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Home
About Us
Insurance Plans
Industry Solutions
Let’s Connect

Home
Insurance Plans
Industry Solutions
Get My Free Quote
About Us
Let’s Connect

Get My Free Quote

Let’s Get You Covered

Quick, simple, and built around your business.

What type of insurance quote do you need?General Contractor InsuranceTowing Operations InsuranceBusiness InsuranceWorkers Compensation InsuranceCommercial Auto Insurance

Legal Business Name *

Business Address *

City *

State/Province

ZIP / Postal Code

Contact Name *

Phone Number *

Email Address *

Years in Business *012345+

Estimated Annual Revenue *

Previous Insurance Coverage *

Claims in the Past Six Years *

DBA / Doing Business As

Mailing Address (if different)

Business Contents Value

Liability Coverage Limit Desired

Additional Comments or Special Needs

First Name *

Last Name

Date of Birth *

Phone Number *

Email *

Street Address *

City

State/Province

ZIP / Postal Code

VIN Number(s) for At Least One Vehicle *

Type of Coverage *

Additional Driver(s) Information

Name

Dates of Birth

Driver’s License Numbers

Currently Insured or Uninsured? *

Claims in the Past Six Years *

Total Square Footage of Location *

Owner or Tenant *

Currently Insured? *

Federal Employer Identification Number (FEIN) *

Total Annual Payroll *

Number of Employees *

Type of Contracting

Claims in the Past 3 Years? *

Desired Liability Coverage Limit

Tools/Equipment Coverage Needed?

Additional Comments or Coverage Needs

Estimated Annual Liquor Sales *

Hours of Operation *

Type of Establishment *

Entertainment

Type of Establishment (e.g., bar, liquor store, gas station, nightclub, etc) *

We specialize in insurance for General Contractors. This form is required to provide an accurate, bindable quote and issue your policy and certificates quickly.

If you’re unable to complete the form or need help, feel free to call or text us at 773-990-9889 for assistance.

Business Name (as it should appear on the policy) *

Mailing Address *

Business Address (if different) *

Website Address

Proposed Effective Date (MM/DD/YYYY) *

Applicant Type (e.g., Individual, Corporation, Partnership, Other): *

Has the insured had 3 years of prior coverage? *

Any prior claims or losses in last 3 years? *

Explain

Describe exact operations *

Years in business under business name *

Approximate % of work by property type (e.g., Residential, Commercial, Industrial) – Total = 100% *

Approximate % of work by project type (e.g., New Construction, Structural Remodeling, Non-Structural Remodeling) – Total = 100% *

Approximate % of your work as: General Contractor, Subcontractor, Construction Manager (Total = 100%) *

License type (e.g., General Contractor, Other): *

Do you use subcontractors? *

Include % subcontracted, total value, and trades with %

Approximate Annual Revenue for the Last 5 Years (List Year + Amount, e.g., 2024: $X, 2023: $Y, etc.) *

Projected annual revenue for this year: *

Number of active owners/officers: *

Number of non-owner employees: *

Approx Annual Payroll for Last 5 Years (List by year – most recent first, e.g., 2024: $X, 2023: $Y…) *

Estimated Annual Payroll for Upcoming Year (Approx total for 2025) *

Approximate Payroll by Job Type (e.g., Carpenter: $X, Laborer: $Y…) *

List Your 4 Largest Completed Projects + Their Values (e.g., Project Name – $X) *

List Your 4 Largest Upcoming Projects + Estimated Values (e.g., Project Name – $X) *

Do you construct new buildings? *

Indicate Residential and/or Commercial:

Do you work on condos, apartments, or tract homes? *

Include type, location, year, value

Will you do similar work in future? *

when and what kind?:

Do you perform seismic or earth movement work? *

Describe:

List all types of work you perform (e.g., demolition, blasting, roofing, mold remediation) *

Any work below grade? *

Approximate average and maximum depth below ground (in feet):

Exterior painting? *

Describe overspray precautions:

Concrete work for additions or foundations? *

Describe

Equipment leased from others? *

Describe

Hazardous material removal? *

Describe:

Do you draw your own plans or blueprints? *

Describe:

Work on hillsides/slopes/landfills/subsidence areas? *

Describe and provide slope:

Work above 4 stories? *

Approximate % of total work done above 4 stories and max working height (in feet)

Use scaffolding? *

List all U.S. states you currently operate in: *

Additional comments or notes:

Business Name: *

Mailing Address (City, State, Zip): *

Business Location (if different from mailing address): *

Primary Contact Name & Phone: *

Briefly describe your towing business: (What types of towing do you do? Light duty? Heavy duty? Roadside? Impound? Etc.) *

What year did your business start? *

Total years of towing industry experience: *

Revenue & Operation Area:

Annual Revenue: Last Year + This Year (e.g., 2023: $X, 2024: $Y): *

Do you operate in multiple states? *

List states

Largest city you operate in: *

Driver Info:

Driver Info: Name, DOB, License #, State, License Class, Years Experience: *

Driver Pay Basis (Hourly, Per Trip, Mileage, Other): *

Are drivers covered by Workers Comp? *

Minimum required driving experience (years): *

Do drivers take vehicles home at night? *

Vehicles & Equipment:

Number + Types of Vehicles Owned (list type & quantity): *

Any Vehicles Leased to You? *

List type and quantity

Any insurance declined, cancelled, or non-renewed? *

Explain

How many Tow Trucks in operation? *

Do you operate Tow Tractor/Trailer Combos? *

Max Number of Units Towed by One Truck: *

Storage & Security (Optional – Skip if Not Applicable):

If you do not store customer vehicles, you can skip these questions.

Number of Vehicle Storage Locations:

Maximum Number of Customer Vehicles Stored (at one time):

Are Customer Vehicles Stored Overnight?

Is Your Storage Yard Fenced and Lighted?

Where Do You Store Customer Vehicle Keys?

Do You Perform Repo Work?

% of Total Tows That Are Repos

Repo Section (Only Answer If You Perform Repossessions):

If your business does not perform repossessions, you can skip this section.

Briefly Describe Your Repo Procedure:

Do You Drive Any Vehicles Away After Repossession?

Number of Repo Plates + Plate Numbers

Do You Use Independent Contractors for Repos?

Number of Vehicles Repossessed Last Year (By Tow Truck / Drive-Away / Subcontractor – list qty for each):

Repo Types by % (Private Auto, Light Truck, Heavy Truck, Trailer, Other – Total = 100%):

Approx % of Repos That Were Voluntary vs Involuntary:

Do Repo Employees Carry Firearms?

Do You Notify Police for Repos?

Who Are Your Primary Repo Clients (Lenders, Finance Companies, etc.):

Need help?
Call our team to speak live at

Lawrence@acc-insurance.com

Call or Text (773) 990-9889

to speak with a live representative

Need help? Call our team to speak live at

(773) 990-9889 Or Lawrence@acc-insurance.com

Contact Us

7667 W 95th St.
Hickory Hills, IL 60457

Lawrence@acc-insurance.com

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Insurance Plans

General Contractor Insurance
Towing Operations Insurance
General Liability Insurance
Business Insurance
Workers Compensation Insurance
Commercial Auto Insurance
Contractors Insurance
Commercial Property Insurance
Garage Keepers Insurance
Liquor Liability & Business Insurance

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