Revis E Smith Insurance AgencyQuote Information needed for Auto/Truck/Motorcycle/Boat Quote Information needed for Home-Rental Quote Information needed for Business Quote Information needed for Life or Health Contact UsProducts/History

Quote Information needed for Business

The fastest way to receive a Business
Insurance quote is to send a copy of your
current insurance declaration page


If you have the time, please send the
information requested below to

Please include your
personal email address
on any

Call if you have any questions
214-536-5540 or office 972-881-5028



(If the machine answers, please leave a message.)

 Business information needed

The Business questionnaire has 3 sections

Section 1 Company contact information
  1. Business Name
  2. Type of Business
  3. EIN (Employer Identification Number)
  4. Contact Name
  5. Business Email
  6. Street Address
  7. City, State, Zip Code
  8. Business Phone
  9. Best Time To Call
  10. Effective Date of Current Insurance Policy
Section 2 Type of Insurance product 
  1. Product Interest: Business Owners Policy
  2. Commercial Property / Liability
  3. Commercial Auto /Truck
  4. Commercial Umbrella
  5. Other types of coverage
Section 3 Current company experience
  1. Year Business Started
  2. Current Commercial Insurance Company
  3. Have you had any previous claims?
  4. Current Annual Sales
  5. Current Number of Employees
  6. Current Years of Experience
  7. Current Location of Supplies
  8. Current Square Footage of Storage
  9. Current Number of Vehicles

Additional products & services can
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