Business Name:    
Premises Address:
City:  
GEORGIA
Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required) 
Description of Operations or SIC code:


Number of Employees:              
Payroll (not including owners): $
Estimated Gross Receipts:       $

Current Insurance Company: 
Policy Expiration Date:          (mm/dd/yyyy)

Please Quote: (check as many boxes as desired)
Owners Insurance
Complete Business Insurance Package

Georgia Property Information

Contents (including inventory): $
Square footage you occupy:
Building Limit (if you own the building) $

Type of Construction:

Electrical Type:             Electrical Renovation Year: 
Amps: 
Plumbing Renovation:     Plumbing Renovation Year:
Heating Type:               Heating Renovation Year:   
Roofing Renovation:       Roof Age (years):  
Sprinkler system in your building?
Burglar Alarm:        Central Station Alarm:

Total Annual Sales: $
Is your store located within 5 miles of any coastline?

Georgia Liability Information

Select all that apply to your Georgia business:
Operate or lease aircraft/watercraft     Work Underground
Work above 15 feet                           Require out of state travel
Use Subcontractors                            Delivery Service
Pre-employment physicals                   Offer safety incentive programs
Store, treat, dispose, or transport hazardour waste
Work on vessels, docks, or bridges over water
Other

General Aggregate Limit (other than products completed):   
Products/Completed Operations Aggregate Limit:                


   Georgia Workers Compensation Information
Class                         Code           Total Payroll
          $
          $
          $

Experience Mod (if any, per policy)
Federal Employer's ID #

Umbrella Insurance Amount Desired:

Additional Information



Click on the "Submit Quote Information" button below to send your
Georgia Business Owners Insurance quote request.**

**Information received from this Georgia Business Owners Insurance quote request form sent to JRS Risk Services will be for our use only and will not be sold, given to or distributed to any other parties. A quote will be based on the Georgia business owners insurance policy information provided and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as issued. By submitting this request you acknowledge that this is neither an offer to insure nor a guarantee of insurance. Completion of this form does not entitle your business to a Georgia Business Owners Insurance policy. We are licensed in Georgia and will not provide business owners insurance quotes for other states.


We are an Atlanta, GA insurance agency offering comprehensive Georgia
business owners insurance quotes to businesses in the following cities and
counties in Georgia: Smyrna, Douglasville, Vinings, Oakdale, Sandy
Springs, Marietta, Riverside, Carey Park, Adamsville, Bolton, Center Hill,
Grove Park, Buckhead, Morningside, Fair Oaks, Privette Heights,
Dunwoody, Chamblee, Doraville, Skyland, Brookhaven, Embry Hills, Oak
Grove, Rehoboth, Vista Grove, East Marietta, Toco Hills, North Druid Hills,
Decatur, Scottdale, Clarkston, Belvedere, Pendley Hills, South Decatur,
Druid Hills, Gresham Park, Avondale Estates, Panthersville, North Decatur,
Cedar Grove, Conley, Forest Park, College Park, East Point, Stockbridge,
Morrow, Riverdale, Stone Mountain, Union City, Mableton, Lithia Springs,
Winston, Douglasville, Austell, Powder Springs, Hiram, Dallas, Kennesaw,
New Hope, Kennesaw, Acworth, Woodstock, Roswell, Alpharetta, Norcross,
Duluth, Gainesville, Buford, Auburn, Winder, Cartersville, Rome, Cedartown,
Peachtree City, Buckhead, Canton, Cumming, Braselton, Sugar Hill,
Hoschton, North Atlanta, Tucker, Pine Lake, Mountain Park, Glen Haven,
Belmont, Redan, Pittsburg, Lilburn, Luxomni, Snellville, Five Forks,
Centerville, Whitney, Pannell, Lithonia, Dialtown, Flint Hill, Conyers,
Milstead, Klondike, Panola, Snapfinger, Magnet, Gloster, Bethesda,
Pleasant Hill, Pittman, Mechanicsville, Meadow, Berkeley Lake,
Lawrenceville, Forest Hills, Suwanee, Northwoods, East Lake, East Atlanta,
Oakhurst, La Vista, Brookhaven, Doraville, Fulton County, Dekalb County,
Forsyth County, Gwinnett County, Walton County, Newton County,
Paulding County, Douglas County, Cherokee County, and Cobb County,
GA. We also offer experienced Georgia business owners insurance
coverage quotes for businesses throughout the Peach state, including in
Macon, Columbus, Augusta, Athens, and Savannah, GA.
JRS Risk Services of Atlanta,
GA offers comprehensive
commercial insurance coverage
options and experienced
business insurance services
throughout Georgia.
Contact us about Georgia
Business Liability, Commercial
Auto, Business Owners,
Professional Liability, and
Business Property Insurance at
(678) 921-4650.
In addition to a Georgia
Business Owners Insurance
quote, we also offer affordable
Business Liability Insurance
quotes.
Georgia Business
Owners Insurance Quote
Georgia Business Information:
We can provide comprehensive Georgia
Business Owners Insurance coverage services
in the Atlanta, GA area and throughout Georgia!
JRS Risk Services
2727 Paces Ferry Rd. SE
Building 1, Suite 260
Atlanta, Georgia 30339
Cobb County, GA
Office: (678) 921-4650
Fax: (678) 921-4651
Your Georgia
Business Owners
Insurance Connection
JRS Risk Services
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