Church Insurance Quote Request
Please provide the following information for your church insurance quote. All fields marked with * are required.

Church Information

Basic information about your church
Required for quote
Physical Address
Is Mailing Address Differant?
Check if your mailing address is different

Contact Information

Add primary and additional contacts for your church

Church Contacts

Contact Name

Organization Details

Legal structure and business information
Organization Type
Tax Status

Coverage Options

Select your desired coverage types and limits
General Liability Limit
Additional Coverage
Check all coverage types you're interested in

Current/Previous Insurance

Information about your existing or previous coverage
Click or drag a file to this area to upload.
Upload your loss runs documentation

Property Information

Details about your church building and property
Estimated replacement cost
Value of contents/equipment
Recent Updates (Last 10 Years)
Property Features
Click or drag files to this area to upload. You can upload up to 10 files.
Upload photos of building and playground
Building Occupancy/Use
Check all that apply
Weekly Daycare Services
If yes, additional daycare information will be required
Playground on Premises
Photos required if playground present

Church Vehicle Drivers

List all drivers of church vehicles. Requirements: Age 22-70, No CDL or Chauffeur license, Must complete DDC Class for 15-passenger vans

Driver Information

Driver Name
DDC Class

Additional Information

Click or drag a file to this area to upload.
Optional: Upload building layout diagram
Clear Signature