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Insurance Resources and Services, Inc. guarantees your Washington insurance purchase satisfaction
Garage/Auto Repair & Fuel Mart
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!

Your Personal / Company Data:

Your Name:
Your Company's Name:
Street Address:
State: (Must be Washington)
Fax (optional):
Your Business Type: Corporation


Currently Insured?
(If yes, list carrier, and Policy Dates.
If none, type NONE)
Current Premium (cost) $
List Claims & Amounts Paid
During Last 5 Years
(If none, type NONE)
Policy Form:
Claims Made    Occurrence
Retroactive Date (if any):
Years In Business:
DOT Shop Identification
Code(s) Number:

Underwriting Information:
Describe IN DETAIL,
Your Business Operations:
Operations Data:
Describe IN DETAIL,
Your Business Operations:
Ownership & Payroll Data:
List Employee's Annual Payroll Here (if none, enter $0): $ Insert # of
Employees here:
Location & Sales Information:
Insert Annual Gross Revenues from this operation here: $ Square Footage of office or business location:
Type of Building (wood frame, concrete, etc.): Number of Stories:
Are there other business/residences in this building (describe)?: Describe safety features (alarm, sprinklers, fire protection, etc):
Provide breakdown percentages of work provided:
Passenger %  Truck %  Off-the-Road %
Coverage Desired: (Check One Please)
Policy Type I am Interested In:
Claims Made Form
Occurrence Form

Limits of Liability Coverage I am Interested In:
$1 Million
$5 Million

Limit of business property needed:

Limit of Garagekeepers Coverage Needed:
(Total amount of vehicle left in your possession.)
NOTE: Don't worry if you are not exactly sure about coverage type... we will suggest the best coverage for you - just try to tell us what you are looking for! (If we need more info. we will let you know.)
Send my quotation via: E-Mail Fax
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Garage/Auto Repair Shop Insurance Quote NOW!

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Insurance Resources & Services, Inc. | 425 - 23rd Avenue S., Suite A206 | Seattle, WA 98144
Phone: 206-728-1757 | Fax: 206-329-1649 | E-Mail us at: dlcason@msn.com

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