LET BANCORP INSURANCE GROUP, THE OREGON CONTRACTORS INSURANCE CONNECTION,
PROVIDE YOU WITH A COMPETITIVE EXPRESS QUOTE WITHIN 24-HOURS.


FINALLY,
THERE IS A SENSIBLE WAY FOR CONTRACTORS TO GET THEIR WORKER'S COMP INSURANCE QUOTED!

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Quick Quotes

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Worker's Compensation
24-Hour Request-A-Quote Form
 

Type of Contractor

Are you currently insured?

Are Owners To Be Covered?

Full Name:
Business Name
Type of Business

CITY, STATE, ZIP
Daytime Phone (include area code)
Home Phone (include area code)

Fax Number

 (include area code)
Email Address
Select Your Current Carrier:

Number of Owners?

List your classifications and payroll * below (it may be helpful to reference your current policy, if any).  See example below AND be sure to include the amounts paid to uninsured subs in the payroll * category.
CODE CLASSIFICATION
Description of Work Performed		 ANNUAL
PAYROLL		 Owner Payroll Included?
1.
2.
3.
4.
5.
6.
List your experience modification (if known):
Please provide a brief description of your operations:

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This is not a binding contract of insurance.
The above obtained information is for the purpose of a Quick Quote
and is subject to the accuracy of the information provided.