> BUSINESS QUOTE Name of Contact: Business Name: Address: Address 2: City: State: Zip: Phone: Work Phone: Fax: Email: Description of Business in detail: Any Employees? Yes No If so, How many corporate officers?: How many other employees?: What is the total annual payroll?: Auto coverage desired? If so, please list vehicles, cost new and drivers: Have you had any claims in the past five years? Yes No If yes, explain: