What type of insurance do you need?
Secured by SSL

Complete Church Quote


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

To ensure you will be contacted directly and in a timely manner, please double check your contact information. After this section, you will have the ability to skip by using the "next page" button at the bottom right of the forms.
First Name
Required
Last Name
Required
Street
Required
City
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
E-Mail Address
Required
Please select how you would like your quote deliverd:
Optional




We look forward to getting your quote started. Please tell us some general information regarding your church.
Named Insured:
Optional
Please list the policy effective date
Optional
/ /
Church Mailing Address, City, State, and Zip
Optional
Church Phone Number (including area code)
Optional
Church Fax Number
Optional
Federal ID #
Optional
Church Entity
Optional
How many members does your church have?
Optional
Church Denomination
Optional
What is the primary operation?
Optional
Prior Insurance Carrier
Optional
Does your church have a formal safety program in operation?
Optional

Is any portion of building/premises rented or leased to others?
Optional

Are any staff members or volunteers part of a mandatory community service program in lieu of going to prison?
Optional

Has your church had any policy or coverage declined, cancelled, or non-renewed in the last 3 years?
Optional

Does church have any past losses or claims relating to sexual abuse or molestation allegations, discrimination, or negligent hiring?
Optional

Loss History: please upload document of your 3 year loss history or manually enter them in box below
Optional
Date of Claim, Type of Claim, Amount Paid, Claim Status (open, closed, pending)
Example: 08/11/2013, hail damage on roof, $1,613, closed
Loss History: list loss information following the format given in example above OR, upload your own loss history document in the box below.
Optional
Select desired limits on the following coverages.
General Aggregate
Optional
Products and Completed Operations
Optional
Personal and Advertising Injury
Optional
Each Occurrence
Optional
Medical Expense
Optional
Check box if additional types of exposure applies to your church
Church Additional Exposures
Optional





Select desired limits on the following coverages:
Liability Limit
Optional
Unisured Motorist
Optional
Hired/Non-Owned
Optional
Number of Employee
Optional
Collision Deductible
Optional
Comprehensive Deductible
Optional
Vehicle #1
Optional


Vehicle #2
Optional


Vehicle #3
Optional


Upload your current classifications or fill in the information below:
Optional
For each class code, please list duties, payroll, and #of full/part-time employees:
Optional
Does your church own, operate, or lease an aircraft or watercraft?
Optional

Does your church perform their own maintenance on roof/steeple?
Optional

Do any volunteers perform regular driving duties on behalf of church?
Optional

Are sub-contractors used?
Optional

If yes, list percent % of work subcontracted.
Optional
Are any employees under 16 or over 60 years of age?
Optional

Are there any seasonal employees?
Optional

Are there any employees with physical handicaps?
Optional

Do any employees travel out of the state?
Optional

Are any athletic teams sponsored by the church?
Optional

Are any employees permanently stationed outside of the United States?
Optional

Do any employees predominately work at home"
Optional

Does the church operate any shelters?
Optional

Are all employees given appropriate training in how to act in event of robbery?
Optional

Does church have cafeterias, soup kitchens, or similar cooking operations at any location?
Optional

Are there any out of country mission trips scheduled ?
Optional

# of Full Time Employees
Optional
# of Part Time Employees
Optional
# of Temporary Employees
Optional
# of Seasonal Employees
Optional
Policies & Practices: Check all that apply
Employment application used during hiring process
Optional
Employment application and/or handbook includes "at will" statement
Optional
Employment application includes authorization to check references and criminal records
Optional
Employment application requires applicant's signature that all representations are true
Optional
Employment application states employer is an equal opportunity employer
Optional
Applicant distributes employee handbook to each employee
Optional
Applicant has written procedures for addressing sexual harassment
Optional
Applicant has written procedures for handling employee grievances
Optional
Applicant has progressive disciplinary program
Optional
Applicant posts all notices required by law
Optional
Applicant has adopted a formal Family Medical Leave Act policy
Optional
All terminations are reviewed by the HR department or person responsible for this function
Optional
Written performance evaluations are provided for all employees
Optional
Supervisory employees are trained the proper use of policies & procedures
Optional
Employment policies & practices have been reviewed & approved by outside legal counsel
Optional
Church Fidelity Bond Coverage ($10,000 max, no deductible)
Optional
Is there an audit done by any of the following?
Optional
Audit frequency?
Optional
Does audit include inventory?
Optional
Audit report is rendered to who?
Optional
Are bank accounts reconciled by someone not authorized to deposit or withdraw?
Optional
Is countersignature required?
Optional
Does your church currently carry Director, Officers and Trustees Liability coverage?
Optional
Has there been any change in Board of Directors in the past year?
Optional
Are Board of Directors elected by membership?
Optional
Have policies/procedures been reviewed by an attorney?
Optional
Are there any incidents or circumstances known to you or any other employee that have not yet been reported to the prior carrier, and for which there is reason to believe that such incident or circumstance may give rise to a future claim?
Optional
If "yes" to the question above, please explain:
Optional
Does your church OWN a camp?
Optional


Notice: Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverage's.  Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company.  If you have any questions, please feel free to contact us.
Per the terms of our
online privacy policy we will not resell your information to any third-party.

Our Customer Feedback

Our latest blogs

  • GuideOne
  • Hanover
  • Hartford
  • Travelers
  • Safeco
  • StateAuto
  • Progressive
  • Carrier
  • Carrier
  • Carrier
Shropshire Insurance
© Copyright. All rights reserved. Powered by Insurance Website Builder