Contact Us States Available Home Page Home PageAlarm Insurance Quick Links Alarm Shield Survey Employment Practices Alarm Shield Benefits
Secured by SSL

Employment Practices Liability


Person To Contact

Company Name
Required
Company Owner
Required
Street
Required
City
Required
State / Province
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
E-Mail Address
Required
First Name
Required
Last Name
Required
Total # of Employees
Required
# of Full Time Employees
Required
# of Part-Time Employees
Required
Any Change In # of Employees Last 12 Months
Required
Any Anticipated Change in # of Employees Next 12 Months
Required
How Many Locations do you have
Required
Have You Been In Business Longer than 3 Years
Required

Do Over 50% of Employees Earn over $ 75,000
Required

Any Locations in Louisana or outside us ?
Required

Do You Currently Have Employment Practices Liability Policy
Required

Current Insurance Provider
Optional
Current Policy End Date
Optional
/ /
Within the last 5 years has any employment related, or third party discrimination, or third party harassment inquiry, complaint , notice of hearing, claim or suit been made against the applicant
Required

Does Applicant have any email or internet policy currently in force ?
Required

Does Applicant have an Anti-Discrimination policy currently in force ?
Required

Any person aware of any fact, circumstances or situation which may result in any employment claim
Required

Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.


Get A Quote Now!

Affliates
Badger
Postcard Mania
Footer Links Home Page Privacy Policy Contact Us Twitter Facebook