Houston Workers Compensation Insurance Quote from Glenn Lamb Farmers Agent

Home | Personal Insurance | Business Insurance | Contact Us

Personal Insurance:

Homeowners Insurance Quotes
Automobile Insurance Quotes
Motorcycle Insurance Quotes
Boatowners Insurance Quotes
Personal Umbrella Quotes
Renters Insurance Quotes
Flood Insurance Quotes
Mobilehome Insurance Quotes
Mobilehome Renters Quotes
Life Insurance Quotes

Business Insurance:

Businessowners
Insurance
Quotes

Workers
Compensation
Quotes

We gladly accept:

LINK TO HOME PAGE

E-Mail:
glamb@farmersagent.com

Local Phone:
281-537-2700

Online Workers Compensation Quote Form One Simple Form - takes only 2-3 Minutes! Your Personal / Company Data:
Your Name:
Your Company's Name:
Street Address:
City:
State:	MUST be Texas!
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again (for accuracy):
Phone:
Fax (optional):


Currently Insured? (If yes, list carrier, and # of years continuous. If none, type NONE)

List Claims & Amounts Paid (If none, type NONE)

Years In Business:

Business type: (proprietorship, corporation, etc.)


Underwriting Information:

Describe IN DETAIL, Your Business Operations:

Payroll Class #1:
List Class Code # if you know it, and describe payroll class:	Insert Annual Payroll in dollars for this class here:	$

Payroll Class #2: (if none, leave blank)
List Class Code # if you know it, and describe payroll class:	Insert Annual Payroll in dollars for this class here:	$

Payroll Class #3: (if none, leave blank)
List Class Code # if you know it, and describe payroll class:	Insert Annual Payroll in dollars for this class here:	$


Send my quotation via:	E-Mail Fax Regular Mail

Thank you for filling out this form COMPLETELY!
We value your input as PRIVATE information. Our intent is to release quote information only to you. By checking the box below you agree to allow our agency to release this Houston workers compensation insurance quote via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Workers Compensation Quote NOW!

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

Lamb Insurance Agency (Farmers Insurance) | 28 FM 1960 West, Houston, TX 77090
Phone: 281-537-2700 Fax: 281-537-8502 Cell: 281-881-5756