Minnesota insurance from Miller Hartwig Insurance Insurance
Meeting the Insurance Needs of Minnesota Residents & Businesses for Decades!
 
Personal Auto, Homeowners Insurance from Miller Hartwig Insurance
Personal Auto Insurance

Homeowners Insurance

Condo & Townhome Insurance

Motorcycle/ATV Insurance

Boat Insurance

Snowmobile Insurance


Business and Contractor Insurance Products from Miller Hartwig Insurance
Businessowners Insurance

Contractor Liability Insurance

Commercial Auto Insurance

Workers Comp Insurance


Life and Health Insurance Products from Miller Hartwig Insurance
Life Insurance

Health Insurance


Other Insurance Services from Miller Hartwig Insurance

More About Our Agency

Our Nine Office Locations

Customers - Service/Claims

Questions? E-Mail Us!

 

On-Line Contractor
General Liability Quote Form
One Simple Form - takes only 2-3 Minutes!
Your Name:
BUSINESS Name:
Mailing Address:
City:
State: (Must be Minnesota)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
Were You Referred to an Agent?
If Yes, Whom?
 
Business Underwriting Information
Type of operation:
Describe operations in detail:
License class:
License Number:
 
Limit of Liability
Coverage Requested?		 $300,000
$500,000
$1 Million
 
Currently Insured? Yes No
Name of Carrier & how long insured?
Prior Claims? Yes No
Describe claims in detail:
 
Years in business:
Years experience in field:
Percentage of work residential:
Percentage of work commercial:
 
Number of Active Owners:
Number of Employees: 0   1   2   3+
Annual Employee Payroll: $
Annual Gross Sales: $
 
Do you subcontract work? Yes No
(If yes, what percentage of your work
is subbed, and what kind of work?)
Do you do foundation work? Yes No
Do you work on condos? Yes No
Employees paid over $18/hour? Yes No
Do you have a safety program? Yes No

 
Comments/Remarks:
 
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Miller Hartwig Insurance . PO Box 1177 . Lakeville, MN 55044
Phone: 1-952-469-0407 | Fax: 1-952-469-1881 | E-Mail us at: quotes@insurance4MN.com
Our Telephone Quoting Hours are: 8:00am to 5:00pm (Mon-Thurs), 8:00am to 3:00pm (Fri)
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