Skip to content
CALL US:
(626) 332-2258
Request a Quote
Menu
Insurance Brokers, Inc.
Home
Our Team
Specialty Nonprofit
What We Offer
Insurance Applications
General Insurance Application
Cyber Security Application
Employment Practice Liability Quote
Special Events Application
Worker’s Compensation
Commercial Insurance Programs
Certificate Request
Insurance for Speech-Language
Resources
Independent Contractor (AB5) Status
Summary of Insurance Coverages
Insurance Terms
Cyber Risk Management
Blog
Contact Us
Close Menu
Employment Practice Liability Quote
Name of Organization
(Required)
FEIN NO.
Physical Address
Street Address
Mailing Address
If different
Contact Person
Email
(Required)
Valid email
Phone
Fax
What are the operations of the organization?
Number of Employees
# Employees Full time
# Employees Part time
# Temporary Seasonal
# Volunteers
# Part time
# of Independent contractors
Has there been an Employment Practice Liability Insurance claim in the past 5 years?
Yes
No
Please explain
Additional Comments
Δ
