Errors & Omissions Insurance Quote

Name *

First

Last

Business Name

Phone (###) ###-#### *

Email *

Confirm Email

What does your business do? *

If you are a Realtor, Broker, or Property Preservation company select the option below that applies.

Address

Address Line 1

Address Line 2

City

State

Zip Code

Is your business operated out of your home?

Other than the business address provided above, how many additional locations does your business own or rent? *

What best describes your business's ownership structure (select one):

Including yourself, how many full-time, part-time, and temporary employees does your business have? *

Do not include subcontractors.

Do you or your business supply, manufacture, or distribute any tangible goods or products?

Does your business perform any design, construction, installation, removal, or physical repair of any property or tangible goods?

Do you currently have an insurance policy in effect for the coverage requested?

If yes, name of insurance carrier:

Date when you would like coverage to start (today or future):

Does your business provide any of the following services?

Insurance agent/broker
Mortgage banker/broker
Title agent/abstractor
Real estate appraiser (for loan valuations, does not apply to brokerage service)
Home inspector
Property developer or builder

Including yourself, how many agents/brokers work for you or your firm (including direct employees and subcontractors)?

Do not include other office support staff.

Are the licenses for all agents working with your firm current, and in good standing with your state's licensing board?

Does your business sell any properties owned by you or an affiliated entity?

Does your business have any exclusive sales relationships with any real estate developer, builder or construction company?

What is you or your firm's approximate average commission received per sale (prior to any sharing arrangements)?

Approximately, what percentage of your commissions are due to the sale of commercial properties?

Approximately, what percentage of your commissions are due to "short sales"?

Approximately, what percentage of your commissions are dual agency sales, where you represent both the buyer and seller in the same transaction?

Approximately when did your business begin?

For the next 12 months, what is your estimated payroll expense for yourself, your full time, part-time, and temporary employees and agents/brokers?

(Please also include agents/brokers that are subcontracted).

What are your business’s estimated gross sales during the next 12 months?

How did you hear about VRM Insurance Agency?

Attach Current Policies or Supporting Documents

Click or drag files to this area to upload. You can upload up to 3 files.

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