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Insurance Quote · Popular

Get Your Commercial Liability Insurance Quote Fast

Collect business details and coverage needs to generate accurate commercial liability insurance quotes for small businesses quickly and securely.

Use This Template Free Preview

Matcha theme

formbuilder.ai/f/small-business-commercial-liability-insurance-quote-request-form

Small Business Commercial Liability Insurance Quote Request Form

Contact Person Full Name

· · ·

Business Email Address

· · ·

Business Phone Number

· · ·

Submit

The Small Business Commercial Liability Insurance Quote Request Form is designed to help insurance agents, brokers, and carriers efficiently gather the essential information needed to generate accurate, customized liability insurance quotes. By capturing key details such as business entity type, industry category, annual revenue, number of employees, and primary business operations, this form streamlines the quoting process from start to finish.

This template is ideal for independent insurance agencies, commercial brokers, and insurtech platforms serving small business owners across any industry. Whether your clients operate as sole proprietors, LLCs, or corporations, the form adapts to collect the right data points — including Federal Tax ID, business locations, and DBA names — ensuring nothing is missed during the intake process.

By moving your quote request process online, you reduce manual back-and-forth, improve data accuracy, and provide a professional first impression to prospective clients. All submissions are kept confidential, building trust from the very first interaction. Customize this free template to match your brand and start receiving complete, actionable quote requests today.

4 Pages

30 Questions

~10min To complete

Free No credit card needed

Field types Short Text ×5 Dropdown ×4 Yes / No ×4 Long Text ×3 number ×3 Single Choice ×2 Full Name Email Phone Website URL currency Address Multiple Choice termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Business Information 8 questions

Business Information

Welcome! Please complete this form to receive a customized commercial liability insurance quote. Our team will review your information and get back to you promptly. All information is kept strictly confidential.

1 Contact Person Full Name * Full Name

2 Business Email Address * Email

3 Business Phone Number * Phone

4 Business Name * Short Text

5 DBA / Trade Name (if applicable) Short Text

6 Business Entity Type * Dropdown

7 Federal Tax ID / EIN * Short Text

8 Business Website Website URL

Page 2 Business Operations & Details 8 questions

Business Operations

1 Describe Your Primary Business Operations * Long Text

2 Industry / Business Category * Dropdown

3 If Other, please specify Short Text

4 Years in Business * number

5 Total Number of Employees (including owners) * number

6 Estimated Annual Revenue * currency

7 Primary Business Location * Address

8 Number of Additional Business Locations number

Page 3 Coverage Requirements 7 questions

Coverage Details

1 Types of Liability Coverage Needed * Multiple Choice

2 Desired Coverage Effective Date * Dropdown

3 Preferred General Liability Limit * Dropdown

4 Do you currently have commercial liability insurance? * Yes / No

5 Current Insurance Provider (if applicable) Short Text

6 Have you had any claims filed against your business in the past 5 years? * Yes / No

7 If yes, please briefly describe the claim(s) Long Text

Page 4 Additional Information & Consent 7 questions

Additional Information

1 Does your business have any contracts requiring specific insurance minimums? * Yes / No

2 Do you need to add any Additional Insureds to the policy? Yes / No

3 Any additional information or special coverage requests? Long Text

4 How did you hear about us? Single Choice

5 Preferred Contact Method * Single Choice

6 I certify that the information provided is accurate and complete to the best of my knowledge. I understand that submitting this form does not bind coverage and that a licensed agent will review my request. * termsandconditions

7 Applicant Signature * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.