Atlanta, Georgia
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Workers Compensation Insurance Quote Online Request

If you own or operate a business in metro Atlanta, Georgia, or anywhere throughout the states of:  Alabama, Florida, Georgia, North Carolina, and Tennessee, InsureUSA can help provide your business with a Workers Compensation insurance quotes or Work Comp insurance coverage.

Business owners and operators, please take a moment to fill out the online Workers Compensation insurance quote online request form below and one of our representatives will contact you with free, no-obligation workers compensation insurance quotes. This information will be kept confidential and will be used for Workers Compensation insurance quote purposes only.

InsureUSA is currently serving small business and large business customers throughout metro Atlanta, Georgia and in the states of Georgia, Alabama, Florida, North Carolina and Tennessee. If your business is not located in one these states, we will not be able to provide you with Workers Compensation insurance coverage, or provide you with Workers Compensation insurance quotes or Work Comp insurance quotes.

* Required fields

General Information
Name of Business:* *
Contact Name:* *
Address:* *
City:* *
State:* *    Zip:* *
Federal Tax ID Number:
Business Phone:   Fax Number
Entity Type:
Best Time To Call:   AM   PM
Contact E-mail:* *Invalid format.
Your Business Website Address:

Current Workers' Comp Insurance Information
Insurance
Carrier Name:
Policy
Expiration Date: 		    Premium Amount: $
NCCI Experience Modification:   If not sure, use "NA".
Years Insured:

About Your Business
Number of
employees 		How long
in business 		How many
locations 		Estimated Annual
Payroll (Gross)
years $
Payroll Information (if known)    
Class Codes Employee Duties Annual Payroll $ Hourly Wage $
Please give a brief description of your business:

Additional Comments or Questions


Please click the "Submit Quote Request" button to send your quote request. No coverage is in effect until bound by an insurance carrier. This is a request for quotation only.