Business Insurance Peoria Any Business and all insurance lines offered Call 309 673-5544 Ledbetter Insurance Business Owners Insurance Quote Form We would love to hear from you! Please fill out this form and we will get in touch with you shortly. 1 Personal Information2 Underwriting Information Type of BusinessSole ProprietorPartnershipLLCCorporationYour NameBusiness Name:Property Address:City:State:IllinoisIndianaIowaMissouriOhioWisconsinZip/Postal Code:Email:* Phone:Fax (Optional):Currently Insured? (If yes, list carrier, and # of years continuous. If none, type NONE)Type of Business:RetailWholesaleOfficeOtherList Claims & Amounts Paid (If none, type NONE)Years In Business:Business type: (proprietorship, corporation, etc.)Describe Business in detail: (i.e., Delicatessen and sandwich shop, etc.) 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):Coverage DesiredThe Coverage I Am Looking For:Liability OnlyLiability & Business ContentsLiability, Building & Contents CoverageA Package Policy Including the Above, Plus Miscellaneous CoveragesNOTE: 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.)Liability Coverage: ($300,000, $500,000, $1 Million, etc.)Business Contents Coverage: (The amount of your personal business property)Building Coverage: (The amount of building coverage if you own your bldg.)Miscellaneous Coverage: (List any special coverage peculiar to your business, such as Garagekeepers Legal, Loss of Earnings, Valuable Papers, etc.)Other Coverages You Would Like Information On:Commercial VehicleBonds, License/PerformanceWorkers CompensationBuilders Risk InsuranceCommercial UmbrellaSend my quotation via:E-MailFaxRegular MailCall me by PhoneContact InformationName* First Last Position*Best Method of Contact*PhoneEmailTextFaxPhone Number*Best Time to Contact* : HH MM AM PM NameThis field is for validation purposes and should be left unchanged.