Mainline Insurance

Contact us Today!

(888)467-6612

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HOW DOES IT WORK?

- Complete our easy Additional Insured request form.

- Once completed, click the “Submit Info” button. The information will be directed to a licensed insurance agent.

- Please remember to include your requester’s fax # or e-mail address.

- Turn around is immediate.  Just sit back and relax!

OR DOWNLOAD & FAX

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PRIVACY POLICY

Mainline-Ins.com does not share your confidential personal information with anyone except the lenders/brokers/agents who receive your inquiry.

Lenders and agents who advertise on Mainline-ins.com may ask for detailed information so they can provide you with more accurate information.

Mainline-ins.com works to maintain the highest professional standards of confidentiality and integrity.

ADDITIONAL INSURED/CERTIFICATE QUESTIONNAIRE

* Job Location

* ***DOES CERTIFICATE HOLDER NEED TO BE ADDED AS ADDITIONAL INSURED? (If yes, please complete the next questions)

Yes No

* Contract cost of the work to be done for the Additional Insured:

$

*Number of field employees (please include owner as an employee) involved on this job for the Additional Insured?

#

* Length of Job:

Month(s)

* Anticipated Start Date:

Would you like to receive an additional insurance quote for:

Commercial Auto
General Liability
Worker's Compensation
Business Property
Professional Liability
Business Owners Policies
Professional Bonds

* Your Business Name

*Your Email

* Your Phone Number

* Entity requesting to be added as Additional Insured

* Phone Number for Entity requesting to be added as Additional Insured

* Fax Number for Entity requesting to be added as Additional Insured

* Address

* City/State/Zip

Is work to be done:
(please mark)

Yes No New Construction
Yes No Remodeling
Yes No Service/Repair Work

All information above is used to determine your quote. Mainline Insurance will not give, trade or sell any of the information you have provided to any individual or company for the purpose of profit or gain.


Mainline Insurance
Contractors General Liability Insurance Providers
P.O. Box 120640
Chula Vista, CA 91912

Phone: 888-467-6612
Fax: 877-467-6610
Lic# 0F23572