What type(s) of insurance are you interested in? * Commercial General Liability Professional Liability/E&O Personal Home or Auto Insurance Online Retailer Insurance Commercial Property (Buildings, machinery, inventory, raw materials etc.) Commercial Auto Small Business Package (Liability + Property) Cyber Liability, Privacy & Data Breach Directors & Officers Liability Commercial & Professional Liability Package Cargo/Shipping Boiler/Equipment Breakdown Environmental/Pollution Surety & Bonding Builders Risk/COC & Wrap Up Liability Cannabis (Retail, Growers, Landlords etc.) Rental Property (Rooming House, Student Rental, Apartment Buildings etc.) Commercial Vessel (P&I, H&M) BCIN Professional Liability Vacant Land, Building or Home Insurance Transaction/M&A/Reps & Warranties Insurance Farm or Hobby Farm ATE/After The Event I'm Interested in Multiple Types of Insurance Other Please click and select the best response.
Additional Insurance You are Interested In Commercial General Liability (including product liability)Online Retailer InsuranceProfessional Liability/E&OCommercial Property (Buildings, machinery, inventory, raw materials etc.)Commercial AutoSmall Business Package (Liability + Property)Cyber Liability, Privacy & Data BreachDirectors & Officers LiabilityCommercial & Professional Liability PackageCargo/ShippingBoiler/Equipment BreakdownEnvironmental/PollutionSurety & BondingBuilders Risk/COC & Wrap Up LiabilityCannabis (Retail, Growers, Landlords etc.)Rental Property (Rooming House, Student Rental, Apartment Buildings etc.)Commercial Vessel (P&I, H&M)Embedded InsuranceBCIN Professional LiabilityVacant Land, Building or Home InsurancePersonal Home or Auto InsuranceOther Select all that apply
What best describes the reason for your request? * Don't currently have insurance I need/want Have insurance, but looking for options for an upcoming renewal I've been working with another broker, but I'm not happy with the service I'm getting Just for information purposes Other Please click and select the best response.
When do you need or want insurance in place by? *
What is the expiration date of the insurance that is in place? *
First Name * Type your answer here...
Last Name * Type your answer here...
What's the best phone number to reach you at? * (XXX) XXX-XXXX
What's Your Email Address? * We just need this to communicate with you and we promise we won't spam you!
What's the complete legal entity or "doing business as" name of the organization or business you're requesting a quote for? * If you are a sole proprietor or the risk is in your personal name kindly just input your first & last name.
Your website (if applicable) Type your answer here...
Street address of the business or location to be insured * Type your answer here...
City * Type your answer here...
Province or State * Type your answer here...
Postal or Zip Code * Type your answer here...
Country * Type your answer here...
What industry best describes your business/operations? N/A as we are not a business, charity or association Retail Professional Services Construction Manufacturing Farming, agriculture, forestry, fishing etc. Mining, quarrying, and oil & gas extraction etc. Charity, Non-profit etc. Wholesale Transportation and warehousing Finance, insurance, fintech, financial services etc. Real estate, rental and leasing Scientific and technical services Technology, IT etc. Administrative and support, waste management and remediation services Educational services Health care and social assistance Arts, entertainment or recreation Hospitality (Restaurants, Bars, Pubs etc.) Lodging & Accommodations (Hotel, motel, AIRBNB etc.) Other We recognize these might not be a perfect fit, but please select one that most closely applies.
Select the option below most accurately reflects your projected sales/revenue, rental income etc. for the next 12 months: N/A as we aren't a business, charity or association Less than $100,000 $100,000 to $300,000 $300,000 to $500,000 $500,000 to $1,000,000 $1,000,000 to $2,000,000 $2,000,000 to $3,000,000 $3,000,000 to $5,000,000 $5,000,000 to $10,000,000 $10,000,000+ Please click and select the best response.
How many employees do you have? N/A as we are not a business, charity or association None...it's just me! 1 - 10 11 - 25 26 - 100 100+ Please click and select the best response.
Briefly describe your business, organization or risk(s) that you would like to insure Kindly tell us about your risk, what do you do, etc. and please include a brief description of all operations, products, services and/or ways you or your organization generates revenue.
Is there anything else you'd like to share with us or think we should know about you, your operations, the risk etc.? Ex. Years of experience, historic claims, insurance requirements from lease, contract etc.
Consent * I accept By clicking "I accept", you are agreeing to our terms of service and authorizing ALIGNED and it's trusted partners to use of the information provided to attempt to secure insurance quotes on your behalf and to contact you about insurance matters and products.
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