Exchange Insurance Logo
Trusted Choice
Call Us Today
620-449-2202
800-697-1656
ONLINE QUOTE CENTER


Exchange Insurance Agency Inc.
718 Central, PO Box 218
St. Paul, Kansas 66771
Get Map

Phone: 620-449-2202
Fax: 620-449-2205
Toll Free: 800-697-1656
Email Us
ONLINE QUOTE FORM

Business Owners Package (BOP) & Commercial Insurance Quote
First & Last Name:  
Business Name:  
Street Address:  
City, State & Zip:  
E-Mail Address:  
Telephone:  
 Fax:  

Current Insurance Information
Insurance Company Name:  
Any Losses in last 3 yrs?:  
Premium Amount:  
Policy Exp. Date:  
Describe the Type of Coverage
you Currently have:
  

About Your Business
# of Full-time
# of Part-time
Yrs. in Business
# of Locations:
Yr. building built
Sprinklered?
Annual Gross Sales
Square Footage?
Building Type:  
Type of Business:  
Owned Autos:  
Est. payroll / mo.:  
Please describe your business here:  
Note: By submitting this form you understand that no coverage is bound until you receive written notice. You also agree to release us from any liability if this information is accidentally viewed by unauthorized persons. We will only use this information for insurance quoting purposes and not distribute to other parties.


Enter the text from the box:
click for new code
Home :: About Us :: Personal :: Auto :: Home :: Commerical :: Online Quotes :: Our Companies :: Contact Us :: Payment Center
Copyright © 2010.  Exchange Insurance Agency Inc.  All rights reserved.    Questions? :: Support :: Site Map :: Privacy Policy