Dean Insurance
37 E. Lee Street
Bel Air, MD 21014
Phone: 410-838-3700
410-879-9030

Dean Insurance welcomes your comments and suggestions!

Please provide the following contact information for your general liability quote:

Name:
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Work Phone:
Home Phone:
Cell Phone :
E-mail:
Requested Effective Date:
Description of Operations:
Presently insured?	Yes No
If Yes name comany:
How long in business?
Years in Trade:
How many employees do you have? (Do Not include Owner):
Annual payroll to non-clerical employees, Excluding Owner(s):
Annual Clerical Payroll:
If retail risk, estimated gross annual sales
Building Contents:
Any Liability Losses in last 3 years?	Yes No
Liability Limits:
Coverage for Tools and Equipment:	Yes No
If yes, total amount of all tools valued less than $500 a piece:
Total amount of all tools/equipment valued in excess of $499:
Any theft losses in last 3 years?	Yes No
If yes, approximatly amount of loss

Please enter your questions or additional comments below: