Insurance

Select a category and fill out the necessary information. Once your quote is submitted, we will contact you shortly via your preferred method.

We offer health insurance through Blue Cross Blue Shield. Because we are based in Texas, we are limited to Blue Cross Blue Shield of Texas. To receive the quickest, most accurate quote on health insurance, please visit the Blue Cross Blue Shield of Texas page directly by clicking on the logo below.

Select a category and fill out the necessary information. Once your quote is submitted, we will contact you shortly via your preferred method.

Personal Auto Insurance Quote

Contact Information

Your Name*

Best way to contact you?*

Contact Email*

How did you hear about us?

Other than price, what are your concerns?

Personal Information

Do you own or rent your home?*

Is this a dwelling or a mobile home?*

How long have you lived at this address?*

If less than 5 years, what was your previous address?

How are the vehicles registered?*

Primary Driver Information

Full Name*

Marital Status*

Date of Birth*

Social Security Number*

Driver's License Number*

List any tickets, accidents and/or claims.*

Has the above named attended defensive driving in the last 3 years?

Add a 2nd Driver to This Policy

Full Name

Marital Status

Date of Birth

Social Security Number

Driver's License Number

List any tickets, accidents and/or claims.

Has the above named attended defensive driving in the last 3 years?

Add a 3rd Driver to This Policy

Full Name

Marital Status

Date of Birth

Social Security Number

Driver's License Number

List any tickets, accidents and/or claims.

Has the above named attended defensive driving in the last 3 years?

Current Insurance Information

Do you currently have insurance?*

If so...

With what company?

What coverage are you carrying now?

Can you provide proof of 6 months prior insurance?

Vehicle Information

Make*

Model*

Year*

VIN Number*

What is this vehicle primarily used for?*

Coverage Desired*

Add a 2nd Vehicle to this Policy

Make

Model

Year

VIN Number

What is this vehicle primarily used for?

Coverage Desired

Add a 3rd Vehicle to this Policy

Make

Model

Year

VIN Number

What is this vehicle primarily used for?

Coverage Desired

Add a 4th Vehicle to this Policy

Make

Model

Year

VIN Number

What is this vehicle primarily used for?

Coverage Desired

Personal Motorcycle Insurance Quote

Contact Information

Your Name*

Best way to contact you?*

Contact Email*

When is the best time to contact you?*

How did you hear about us?

S.S.N. (Optional)

Credit History*

Current Insurance Information

Do you currently have insurance?*

Current insurance company*

What is your current premium? (optional)

How long have you been with your current insurance company?*

Current policy expiration date*

Coverage

What liability limit would you like quoted?*

Would you like comprehensive coverage to apply to this motorcycle? Comprehensive coverage includes things like theft or other damage not caused by a collision with another vehicle.*

How much comprehensive coverage would you like us to quote?*

Would you like collision coverage to apply to this motorcycle?*

How much collision coverage would you like us to quote?*

Primary Driver Information

Your Name*

S.S.N. (Optional)

License Status*

Current U.S. state license status*

Drivers license number*

Age the driver was first licensed*

Date of Birth*

Driver's occupation*

Driver's relationship to you*

Highest level of education driver has completed*

Driver's gender*

Marital status*

Has this driver been ordered by the court to carry an SR-22 in the past 5 years?*

Has this driver had any accidents in the past 5 years?*

Vehicle Information

Make*

Model*

Year*

VIN number*

Describe the ownership of this motorcycle*

Name and address of leasing institution

Name and address of lending institution

Primary use of this motorcycle*

Engine size*

Will you keep this motorcycle at your primary residence?*

Address and description of where motorcycle will be stored

How is this motorcycle secured?*

Are there any special accessories?*

What is the dollar value of the accessories?

Does this motorcycle have any special modifications?*

Please describe

Optional Comments

Comments and questions

Personal Home Owners Insurance Quote

Contact Information

Your Name*

Best way to contact you?*

Contact Email*

How did you hear about us?

Other than price, what are your concerns?

Primary insured's information

How long have you lived at this address?*

If less than 5 years, what was your previous address?

If new purchase, when is the closing date? (optional)

Full Name*

Insured's relationship to you*

Marital status*

Date of Birth*

Social Security Number

Add a 2nd Driver to This Policy

Full Name*

Relationship to you*

Marital Status*

Date of Birth*

Social Security Number

Add a 3rd Driver to This Policy

Full Name*

Relationship to you*

Marital Status*

Date of Birth*

Social Security Number

Current Insurance Information

Do you currently have homeowners insurance?*

What company do you currently have homeowners insurance with?*

How long have you had coverage?*

When does the policy expire?

Have you had any claims in the last 5 years?*

Home Information

What year was the home built?*

Does the home sit on more than 10 acres?*

Number of square feet*

Total bathrooms (include .5 and .75 baths)*

Total bedrooms*

Total number of rooms*

Total number of fireplaces*

Does the home have a garage?*

If yes, for how many vehicles?*

Does the home have a carport?*

If yes, for how many vehicles?*

Does the home have storage sheds?*

If yes, for how many sheds?*

Does the home have central heat and air?*

Exterior of home*

Type of roof*

Roof age*

Type of Flooring. Fill in the blanks with the percentage of that type of flooring in the home. For example, 80% carpet, 20% tile, 0% hardwood, 0% linoleum.

% Carpet*

% Tile*

% Hardwood*

% Linoleum*

Deadbolt locks on all exterior doors?*

Fire extinguisher in home?*

Smoke detectors in home?*

Does the home have an alarm system?*

Does the home have a swimming pool?*

Will the home have a trampoline?*

Location of property*

Distance to nearest fire department (include the name of the fire dept.)*

Distance to nearest fire hydrant*

Will pets be in the home?*

Will any business be conducted on the premises?*

If yes, what type of business?*

Personal Umbrella Insurance Quote

Contact Information

Your Name*

Best way to contact you?*

Home phone number*

Contact Email*

How did you hear about us?

Other than price, what are your concerns?

Coverage

What umbrella limit would you like quoted?*

How many residences do you own or occupy?*

Do you own any vehicles?*

If yes, how many vehicles are in your household?*

First and last name of primary driver in your household*

Date of Birth*

Driver's license number*

State where driver's license was issued*

Occupation*

Do you own any boats?*

If yes, how many boats do you own?*

Where is the boat(s) moored or kept?*

Names of all drivers who operate the boat

Do you own any all-terrain vehicles? (ATVs)*

If yes, how many ATVs do you own?*

Does the home have a swimming pool?*

Does the swimming pool have a spring board or diving board?*

Does the swimming pool have a slide?*

Current Insurance Information

Have you had any claims on your personal policies in the past 5 years?*

If yes, please describe*

Do you have policies that are not written through our agency?*

If yes, please describe*

Optional Comments

Comments or additional information (optional)

Commercial Auto Insurance Quote

Contact Information

Your Name*

Address*

Best way to contact you?*

Phone Number*

Contact Email*

When is the best time to contact you?*

Please describe your business*

Vehicle Information

Make*

Model*

Year*

17-character vehicle identification number (VIN)*

Is this vehicle a truck?*

If yes, what is the gross vehicle weight?*

Do you have a loan on this vehicle?*

If yes, name and address of financial institution*

Do you lease this vehicle?*

If yes, name and address of financial institution*

Who is the registered owner of the vehicle?*

How will this vehicle be used?*

If other, please describe

Is there any customization on the vehicle?*

If yes, please describe and indicate the value*

Where will this vehicle be parked at the end of the day?*

What is your radius of operation with this vehicle?*

What is the cost new of this vehicle?*

Primary Driver Information

Driver's Full Name*

Prefix*

Date of Birth*

Gender*

Marital Status*

Driver's license number*

State where driver's license was issued*

Current license status*

Coverage

What liability limit would you like us to quote?*

What uninsured/underinsured motorist limit would you like us to quote?*

Would you like comprehensive coverage on the vehicle?*

If yes, what deductible would you like quoted for the comprehensive coverage?*

Would you like collision coverage on the vehicle?*

If yes, what deductible would you like quoted for the collision coverage?*

Would you like rental reimbursement to apply to the vehicle? This coverage is not available for trucks or tractors*

Would you like towing coverage to apply to the vehicle? Towing coverage is not available for trucks and tractors*

Current Insurance Information

Do you currently have insurance for your commercial auto?*

Name of insurance company*

Policy Number*

Date coverage expires

Reason for requesting a quote*

Additional Information

How did you hear about us?

Comments and Questions (optional)

Did You Know that you need special coverage for an employee who drives a company car and does not have a personal auto in his/her household?

Would you like someone to contact you about this?*

Commercial Property Insurance Quote

Contact & Personal Information

Your Name*

Name of Business*

Business Phone*

Mobile Phone*

Contact Email*

Website (optional)*

Type of Business*

Physical address of business*

Mailing address*

New in business*

Number of years experience*

Property Information

Location of business*

No. of miles from fire dept.*

No. of miles from fire hydrant*

Occupancy*

Annual receipts (if lessor's risk)*

Square Feet of Building*

Square Feet of Parking Lot*

Building Value*

Business Personal Property Value*

Construction Type*

Year Built*

Describe any recent renovations*

Name and address of Mortgagee*

Current Insurance Information

Do you currently have commercial property insurance?*

Name of insurance company*

Date coverage expires

Coverage

Do you need General Liability Insurance?*

Do you need Workers Comp Insurance?*

Do you need Automobile Insurance?*

Business Owner’s Policy Quote

Contact & Business Information

Contact Name*

Contact Email*

Phone*

Please describe your business*

What is your business address*

How many years have you been in business?*

Type of Business*

What is your expected revenue (sales) for the next 12 months?*

How many employees do you have?*

Property Information

Do you own the building you are located in?*

Is there a mortgage on the building?*

What year was the building built?*

Describe any updates to roof, heating, and electrical systems*

What is the construction of the building?*

How far away is the building from a fire hydrant?*

What is the square foot area of the building? Indicate the square foot area for the portion of the building that you occupy *

Do you have a sign?*

Is the sign attached to the building?*

What is the value of the sign?*

Does the building have glass plates?*

Please provide the dimensions of the glass by plate*

What is the value of your contents? (including inventory)*

Does your inventory value fluctuate more than 25% for a certain season?*

Do you have possession of property of others as a general course of business?*

If, yes please describe*

Coverage

Non-Canadian businesses, what liability limit would you like us to quote?*

CANADIAN businesses, what liability limit would you like us to quote?*

Would you like employee benefits liability included in the quote?*

Do you own any vehicles?*

Current Insurance Information

Do you currently have insurance for your business?*

Name of insurance company*

What is the amount of building coverage on your current policy?*

Policy number*

Date coverage expires

Please describe any claims you have had in the past five years*

Additional Information

How did you hear about us?

Comments and questions (optional)

Commercial Umbrella Policy Quote

Contact & Business Information

What is the name of your business?*

What is your address?*

What is your name?*

What is your phone number*

What is your Email address?*

Please describe your business*

What is your total estimated revenue (sales) for the coming 12 months?*

How many power vehicles are included in the business fleet?*

Current Insurance Information

Will this umbrella policy be in addition to another umbrella policy?*

Do you currently have general liability coverage?*

What is the occurance limit of your existing general liability policy*

What is the name of the insurance company who writes the general liability policy?*

What is your general liability policy number?*

What is the policy term for your general liability policy?*

Do you currently have commercial auto coverage?*

What is the occurance limit of your existing auto liability policy*

What is the name of the insurance company who writes the auto liability policy?*

What is your auto liability policy number?*

What is the policy term for your auto liability policy?*

Do you currently have worker's compensation employers' liability coverage?*

What is the employer's liability limit of your existing workers' compensation policy?*

What is the name of the insurance company who writes the workers' compensation policy?*

What is your workers' compensation policy number?*

What is the policy term for your workers' compensation policy?*

Do you currently have employee benefits liability?*

Do you currently have any professional liability?*

If you have professional liability, please describe*

What date would you like this quote to be effective?

Coverage

What umbrella limit would you like us to quote?*

Additional Information

How did you hear about us?

Comments and questions (optional)

General Liability Policy Quote

Contact & Business Information

Contact name?*

Email address?*

Business phone*

Mobile phone*

Website (optional)

Description of Operations*

Nature of Business*

Business Address*

Mailing Address*

Number of locations*

New business*

Number of years experience*

What type of entity is the business*

Annual payroll*

Annual sales*

How many employees do you have*

Coverage

What liability limit would you like us to quote?*

Do you need Auto Insurance?*

Do you need worker comp insurance?*

Do you need property insurance?*

Current Insurance Information

Do you currently have liability insurance?*

What is the name of the insurance company?*

What is the liability limit on your current policy?*

Date coverage expires

Additional Information

How did you hear about us?

Comments and questions (optional)

Professional Liability Policy Quote

Contact Information

Contact name?*

Address*

City*

State*

Zip*

Email address*

Phone*

When is the best time to contact you?*

Business Information

What is the nature of your business?*

Year business started*

Owner's years of experience in the business*

Number of owners and/or partners*

Number of part-time employees*

Number of full-time employees*

Number of sub-contractors*

How many transactions do you process each month?*

Do you have a bank account?*

What type of entity is the business?*

Coverage

What liability limit would you like quoted?*

Current Insurance Information

Do you currently have professional liability insurance?*

What is the name of the insurance company?*

What is the policy number?*

Date coverage expires

What is your annual premium?*

What is the reason you are requesting a quote?*

Additional Information

How did you hear about us?

Comments and questions (optional)

Employment Practices Liability Quote

Contact Information

Name*

Email address*

Phone Number*

When is the best time to contact you?*

Business Information

Type of business*

Year business was organized*

Do you have any subsidiaries?*

If yes, please describe*

Number of full-time employees*

Number of part-time employees*

Number of employees within salary range of $1 to $30,000*

Number of employees within salary range of $30,001 to $50,000*

Number of employees within salary range of $50,001 to $100,000*

Number of employees with a salary higher than $100,001*

Within the past 5 years, has any administrative hearing/claim been made or is now pending?*

If yes, please describe*

Is any person aware of any fact or circumstance that may give rise to a claim under this policy?*

If yes, please describe*

Do you have written policies/procedures on hiring and firing?*

Do you have written policies/procedures on sexual harassment?*

Do you have written policies/procedures on discrimination?*

Do you have a human resource department?*

Has there been or is there expected to be any reduction in staff in the past/future 12 months?*

If yes, please describe*

Do you have an "Employment at Will" statement?*

Current Insurance Information

Is employment practices liability coverage in place currently?*

If yes, who is the current insurance carrier?*

Date coverage expires

What date did you first have this coverage?*

Additional Information

How did you hear about us?

Comments and questions (optional)

Workers Comp Policy Quote

Contact Information

Name*

Name of business*

Business Address*

Mailing Address*

Business Phone*

Mobile Phone*

Email address*

Website (optional)

Business Information

What type of entity is the business?*

Fed ID#*

SIC Code*

Experience Modifier*

If yes, which is...*

Description of your business?*

What is the nature of your business?*

Primary Location*

Other locations (optional)*

Annual payroll*

Number of employees*

Payroll broken down by classes*

Loss Runs - last 5 years*

Would you like the payroll for the owner, partners, or principals included or excluded?*

Indicate the classification and payroll amount for the excluded officers*

Current Insurance Information

Do you currently have worker's comp insurance?*

Insurance company?*

Date coverage expires

Additional Information

How did you hear about us?

Comments and questions (optional)