Imperial Agency of Pennsylvania - fast free PA Insuance Quotes Pennsylvania Insurance quotes

click here for instant insurance quotes!
Low Cost Auto insurance for PA residents and businesses from the Imperial Agency


How Can We Help Today?

Instant Home or Auto Insurance Quote click for business and commercial insurance quote
click for contractor's liability insurance quote
click for garagekeepers  insurance quote
click for cargo, bobtail and truck insurance quote

click for motorcycle insurance quote
click for homeowners quote
click for renters quote
click for personal umbrella insurance quote
click for more about our notary services
Free Online INSTANT Auto Quote from Progressive:

Learn More About Our Agency
Office Map/Directions
Policy Service/Certificates
Our Notary Notice
Our Privacy Notice
Our Mobile Site


 
Garage/Auto Repair Shop
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Personal / Company Data:

Your Name:
Your Company's Name:
Street Address:
City:
State: (Must be Pennsylvania)
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):
Your Business Type: Corporation
Partnership
Individual
Other

 


Currently Insured?
(If yes, list carrier, and Policy Dates.
If none, type NONE)
 
Current Premium (cost) $
 
List Claims & Amounts Paid
During Last 5 Years
(If none, type NONE)
 
Policy Form:
Claims Made    Occurrence
 
Retroactive Date (if any):
 
Years In Business:
 
DOT Shop Identification
Code(s) Number:
 


 
Underwriting Information:
 
Describe IN DETAIL,
Your Business Operations:
 
Operations Data:
Describe IN DETAIL,
Your Business Operations:
 
Ownership & Payroll Data:
List Employee's Annual Payroll Here (if none, enter $0): $ Insert # of
Employees here:
 
Location & Sales Information:
Insert Annual Gross Revenues from this operation here: $ Square Footage of office or business location:
 
Type of Building (wood frame, concrete, etc.): Number of Stories:
 
Are there other business/residences in this building (describe)?: Describe safety features (alarm, sprinklers, fire protection, etc):
Provide breakdown percentages of work provided:
Passenger %  Truck %  Off-the-Road %
 
Coverage Desired: (Check One Please)
Policy Type I am Interested In:
Claims Made Form
Occurrence Form

Limits of Liability Coverage I am Interested In:
$250,000
$500,000
$1 Million
$5 Million

Limit of business property needed:
$

Limit of Garagekeepers Coverage Needed:
(Total amount of vehicle left in your possession.)
$
NOTE: Don't worry if you are not exactly sure about coverage type... we will suggest the best coverage for you - just try to tell us what you are looking for! (If we need more info. we will let you know.)
 
 
Send my quotation via: E-Mail Fax
Regular Mail
Please Call by Phone!

 
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Garage/Auto Repair Shop Insurance Quote NOW!


Help Us Fight SPAM! Please enter the code#
below in the box, to show you are human!

CAPTCHA Image
Reload Image

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!


We Represent These Fine Insurance Companies & More!
the many carriers Imperial Agency.com represents
The Imperial Agency Main Office: 193 W. City Avenue  |  Bala-Cynwyd, PA 19004  |  Phone: 610-617-8850  |  Fax: 610-617-8635
Philadelphia Mayfair Shopping Center Office: 6420 Frankford Ave., #U21  |  Philadelphia, PA 19149  |  Phone: 215-624-5220  |  Fax: 215-624-1197
Policy Service  |  Privacy Notice  | About Our Agency


Visit Our Specialty Insurance Web Sites & Start Saving!

Philadelphia Motorcycle Insurance
Pennsylvania Contractors Insurance
Philadelphia Homeowners Insurance
Pennsylvania Homeowners Insurance
Pennsylvania Renters Insurance
Pennsylvania Truck Insurance
Imperial Auto & Truck Tags


Web Site Design © 2014 Insurance-Web-Sales