American Patriot Insurance - Taxi & Sedan
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CONTACT US


We are insurance specialists for professional artisan and roofing contractors.
Complete the form below and we'll get back to you right away.

Your Full Name:

Your Email Address:
Company Name:
Street Address:
City:
State:
Zip:
County:
Work Phone:
Mobile Phone:
Fax:
Are you interested in...
(check all that apply)

Commercial Auto Insurance
Commercial Property Insurance
General Liability Insurance
Umbrella Liability Insurance
Worker Compensation
OfficePro PEO
Safety & Loss Control Programs



Please complete the information below for the contractor or the agent's client/insured.
Are you currently insured?

Yes, I am currently insured
No, I am not currently insured

If yes, when does your current policy expire?
If yes, who are you
currently insured with?
What type of
business are you in?
What year was
your business established?
How many locations
do you have?
Do you own or lease your primary office space?
How many years have you been in your current location?
Number of employees?
Number of company vehicles?
Approximate
annual gross revenue?
Have you been named in a lawsuit in the past year?
Yes
No
If yes, briefly explain.
How did you hear about us?