Kentucky Daycare Liability Insurance Quote from Eugene Wilson & Co. LLC Insurance Agency of Bardstown, KY

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Phone: 1-502-348-5921
Fax: 1-502-331-0023
Toll Free: 1-800-999-5921

602 Bloomfield Road
Bardstown, KY 40004

KY Insurance License #'s:
354252 and 354251

"All Our Policies Come With an Agent!"

On-Line Daycare Liability Quote Form One Simple Form - takes only 2-3 Minutes! Your Personal Data
Your Name:
Business/Daycare Name:
Property Address:
City:
State:	MUST be Kentucky
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Underwriting Information

Date Coverage Needed:

Prior Carrier:

Describe Business:

Gross Monthly Receipts:	$

Average Number of Children in Daycare:

Ages of children in daycare:

Number of Employees (in ADDITION to owner):

Gross Annual Payroll:	$

Square Footage of Office or Business location:

Describe any outside exercise or playground equipment:

Describe any field trips or excursions taken:

Prior Claims?	Yes No
Describe claims in detail:

Limits & Coverages:

Liability Limits: $100,000 $300,000
$500,000 $1 Million

Comments/Remarks:

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