Don Brown Agency Commercial Quote

"Serving clients on the Web 24 hours a day since 1994 with interactive applications and email insurance endorsements and needs communications".

Thank you for the opportunity to be of service.

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Questions & Endorsements

Commercial Insurance Quote

Please Note: All company operations and information will be held in strict client/agent fiduciary confidence. We can only provide quotes for Oregon and Washington


Step 1. Company:
Contact Name:
Email address:
Company Name:
Street Address:


City, State & Zip:	-
Phone Number:
Fax Number:	(optional)


Step 2. Operations:
Description:
Payroll:
Sales Volume (gross):
Number of Employees:
Years in Business:


Step 3. Building Information.
Building:	if owned enter building value
Year Built:
Construction:
Earthquake Coverage:

Step 4. Insurance Information.

Present Company

Workman's Comprehensive Insurance Needed
(if needed, we will e-mail a separate application)

General Liability

Business Property Amount
(Includes inventory, furniture, fixtures, and supplies.)

Professional Liability (if needed)
(Special application required in some cases)

Bonds Needed

Business Auto Coverage Needed
(If yes, we will email a separate application.)


Step 5. Inland Marine Coverage (heavy equipment or specialty machines).
	Item Description	Value	Model /Year
#1
#2
#3
#4
(Include additional items in the remarks section below)

Step 6. Miscellaneous.

If you have any special requests, please list in the remarks section below. Also, please list any losses in the last three years, or fax a loss report to us at (503) 667-3887

Enter any additional comments or questions you may have for our Customer Service Department