Specialized Insurance Quote Request

Please fill in below form and we’ll get started right away. A dedicated insurance specialist will be in touch shortly. Thank you for choosing Edwards and Company. Dear Business Owner, please fill in below information and we will respond shortly. Thank you for choosing Edwards and Company.

Available Commercial Lines Policies:*
- Construction
- Roofers Edge
- Financial Institutions
- Welding Supply Dealers
- Direct Mail / Marketing
Name*
First Last
Years in Business*
Company Name*
Annual Sales*
Current Insurance Carrier
Expiration Date
MM slash DD slash YYYY
Address*
Street Address City State ZIP Code
Number of Claims in the past 5 years
Your Email*
Phone Number*
Fax Number
Additional Comments
Upload a copy of your current policy
Accepted file types: pdf, doc, ppt, xls, jpg, png, gif, Max. file size: 256 MB.