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IOA Quick Facts

  • Florida’s Largest Privately Owned Insurance Agency
  • The Nation’s 8th Largest Privately Owned Agency – Insurance Journal
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  • One Stop Shop for all of Your Business Insurance & Commercial Insurance Needs
    		•    
    On-Line Workers Comp
    Insurance Quote Form
    One Simple Form - takes only 2-3 Minutes!
    Your Personal / Company Data:

    Your Name:
    Your Company's Name:
    Street Address:
    City:
    State: (Must be Florida)
    Zip/Postal:
    E-Mail (REQUIRED):
    E-Mail again (for accuracy):
    Phone:
    Fax (optional):
     

    Currently Insured?
    (If yes, list carrier, and # of years
    continuous. If none, type NONE)
     
    List Claims & Amounts Paid
    (If none, type NONE)
     
    Years In Business:
     
    Business type:
    (proprietorship, corporation, etc.)
     
    FEIN or Social Security #:
    (now required by all comp carriers to quote)
     

     
    Underwriting Information:
     
    Describe IN DETAIL,
    Your Business Operations:
     
    Payroll Class #1:
    List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this
    class here:     		$
     
    Payroll Class #2: (if none, leave blank)
    List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this
    class here:     		$
     
    Payroll Class #3: (if none, leave blank)
    List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this
    class here:     		$
     
     
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    Tampa Commercial Insurance (An Affiliate of Insurance Office of America)
    4915 West Cypress Street | Tampa, FL 33607 | Phone: 813-358-4330 | Fax: 813-637-8484
    Email: paul.allard@ioausa.com | Florida Insurance License #: W516422