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Kopec Flagler County Chamber

Flagler County’s Preferred Insurance Agency

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Business Insurance Quote

Business Name:
Work Phone:
Home Phone:
Cell Phone:
How Did You Hear
About Us?:
Referral (please specify)
Internet (please specify)
Community First Yellow Pages (employee group photo on
  cover, glossy pages)
Flagler Chamber of Commerce Phonebook (scenic
  beach/dolphin photo cover)
Yellow Book Phonebook- Flagler County Directory &
  Shopping Guide (yellow cover)
AT&T (Bellsouth) Phonebook
Other (please specify)
Type of insurance needed:
Please use our Get A Quote - Auto page for business autos and commercial fleet vehicles.
Years in business:
Number of Employees  
Full Time:
Part Time:
Estimated annual sales:
Estimated annual payroll:
Owner or tenant? Owner   Tenant
Building year built:
Building (or unit) square feet:
Desired building coverage limit::
Personal property limit:
General liability limit desired:
Prior/Current Carrier:
Current premium amount per month:
Current policy expiration date:
Brief description of business operations:

Don't forget to have our office review your entire insurance portfolio
including auto, home, marine, life, and business insurance.
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