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Commercial General Liability

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Email*
Phone*

If you have a spreadsheet or declaration pages to upload, please upload here.
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General Aggregate Liability Limit
- $300k/$600k
- $500k
- $1mil/$2mil
- $1mil/$3mil

What is the nature of the business? Annual Payroll ($) Projected Revenue ($)

Do you rent or loan equipment to others?
- Yes
- No
What equipment do you rent or loan to others?
Equipment Type of Equipment (Small tools and/or large equipment?) Instructions given? (Y/N)

Do you lease employees to or from other employers?
- Yes
- No
Who do you lease to (if applicable)?
Name of Employer Workers compensation coverage carried? (Y/N)
Who do you lease from (if applicable)?
Name of Employer Workers compensation coverage carried? (Y/N)

Is there a formal, written safety and security policy in effect?
- Yes
- No
Explain.

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This site serves residents of the AAA Club Alliance service area which includes Greater Hartford, CT Area, Cincinnati Tri-State Area, Miami County, OH, Greater Dayton, OH Area, Northwest Ohio, AAA Blue Grass & Bluefield Regions, Southern West Virginia, Kansas, Oklahoma, South Dakota, Delaware, Maryland, Washington DC, and parts of Virginia, Pennsylvania, and New Jersey. Write Us: AAA Club Alliance, One River Place, Wilmington, DE 19801

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Josh Hass Insurance

Address

214 E Choctaw Ave.
McAlester, OK 74501

Hours

MON-THURS : 9AM - 5PM
FRIDAY : 9AM - 4PM

Phone

Email

office@joshhass.agency

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