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- ONLINE QUOTE APPLICATION
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APPLY FOR WORKERS COMP QUOTES WITHOUT THE HASSLE
We have you Covered

ONLINE WORKERS COMPENSATION QUOTE APPLICATION

Complete our quick and easy Online Application below
or download our fillable PDF Quote Application here:

chiefins_wc_quote_app.pdf
File Size:	220 kb
File Type:	pdf

Download File

* Indicates required field

Company Name *

Applicant Name *

First

Last

Email *

Phone Number *

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Website *

Type of Company *

Estimated Annual Payroll *

Number of Full-Time Employees *

Number of Part-Time Employees *

Number of Locations *

Years in Business *

Description of Operations *

Policy Effective Month? *

Which States need coverage? *

How many years of prior coverage? *

Current Insurance Carrier? *

Select addition products/services of interest: *

Commercial Liability Insurance Workplace Safety Business Owners Policy Employment Practices Liability Insurance Payroll Services PEO (Professional Employer Organization TeleTriage Other

How did you hear about us? *

Google Search Social Media Referral Email Other

Redemption Code: *

Enter Redemption Code found on your Pre-Approval Letter or Email. If you do not have a Redemption Code, enter "N/A"

Submit

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Chief Insurance Solutions LLC was founded to reduce the cost and hassle of workers' compensation insurance for employers of all kinds and sizes. With our in-depth knowledge and vast experience, we make securing the best workers’ compensation insurance coverage solutions on the market as affordable and hassle-free as possible.

To speak with a friendly and expert broker call (866) 308-3351 or email us Today

HOME
WORKERS COMPENSATION
- ONLINE QUOTE APPLICATION
- QUOTE PRE-REGISTRATION
WHO WE INSURE
- INDUSTRIES WE SERVE >
- LOCATIONS WE SERVE >
  - California
  - Texas
  - Nevada
RESOURCES
CONTACT

APPLY FOR WORKERS COMP QUOTES WITHOUT THE HASSLEWe have you Covered

ONLINE WORKERS COMPENSATION QUOTE APPLICATION

APPLY FOR WORKERS COMP QUOTES WITHOUT THE HASSLE
We have you Covered