Gamboa & Morton Insurance Agency

Commercial Insurance

Quote Request Form

Tel: (415) 282-5888

for California Residents & International Tourists

Let us help you with our expert knowledge & experience!

Please contact me to see if I am eligible for company hidden discounts!

This process does not bind coverage!


How did you find us? URL or Search Engine Name:
Internet Newspaper Ad Radio Ad A Friend Family Other: Specify
Have we quoted you before?  Yes  No If yes, when? Product(s):
                                                                                                                                           mm/dd/yyyy
Are you currently or previously insured with us? No Yes    Insurance Product(s):

Business Name
Applicant Name Mr. Mrs.  Miss Ms.
 First Name: Middle Name: Last Name:

III, Jr.
 
Email Address: Nation: County:
USA Canada Mexico Other: " required
Telephone Numbers:
Home: Work: Fax: Back #
Address:
Street # Street Name Suite / PO # City Province/State: Zip Code
Do you need Certificates of Insurance? Yes No How many?
Do you need to name Additional Insureds*? Yes No How many?
*(Try to avoid contracts that require naming someone else as an additional insured. However, Whenever you can, always be named as an additional insured on any work you subcontract out.
Business type: SIC Code (if known)
Or pick from the list below:
Sample List of Businesses

Air Conditioning Service & Installation

Alarm System Installation

Antique Store

Antique Dealers

Apartment Houses

Apparel Store

Appliance Sales, Service & Installation

Arcades Video & Pinball

Artisan or Contractor

Auto Accessories

Auto Body & Paint Shop

Auto Detailers - Mobile & Hand Car Wash

Auto Liability & Physical Damage
 Auto Part Store Auto Repair Shop

Candy Stores

Card Shops

Carpet Sales, Cleaning, Installation

Car Washes

Carpenters

Ceramics & China Sales

Check Cashing Services

Cleaning or Custodial Services

Clothing Stores

Coin Operated Laundries

Coin & Stamp Dealers

Commercial Buildings

Concrete Pumpers

Construction
  Contractor - Janitorial

Contractor - other

Cosmetologists

Custodial Services

Department Stores

Door & Window Installation

Dry Cleaners & Laundries

Electricians

Electronic Stores: TV's, Radios, etc.

Fabric Stores

Fence Repair & Installation

Florists

Food & Beverage Stores

Furniture Stores

Full Service Car Wash

Gardeners

Gas Service Station

Glass Merchants & Glaziers 

Golf Shops

Grocery Stores
  

Hardware Stores

Hotel / Motel

Ice Cream Parlors

Insurance Agencies
Janitorial Services

Jewelry Stores & Watch Repair

Junior / Mini Markets

Laundries & Dry Cleaners

Liquor Stores

Mail / Office Centers

Markets

Mini-Shopping Centers

Motel / Hotel

Music Stores (CD's, Tapes, etc..)

Musical Instruments

Night Club

Nurseries (botanical)

Offices

Office / Mail Centers

Paint & Wallpaper Sales

Painters

Pastry Shop

Pawn Shops

Pet Supply Stores

Photo Studio

Photo Developers

Photo Suppliers

Plumbers

Printers
    

Rental - Video

Repair Shop

Restaurants

Retail Stores

Rug Sales

Self Service Car Washes

Service Station

Shoe Stores

Shoe Repair

Shopping Centers

Sign Installation

Sign Manufacturing

Social Services

Stationery Stores

Subcontractors
  Swimming Pool Maintenance Services  

Tailor & Alteration Shops

Telecommunications or Video Cable Plant Installation ServicesTrophy Sales

Trophy Sales

Upholstery Shops - Auto

Upholstery Shops - Furniture
Video & Pinball Arcades Video Cable Plant Installation Services or Telecommunications Video Rental & Sales Stores

Watch Repair

Yogurt Shops
...And Many More

Additional Information:
Do you currently have insurance? YesNo
Expires:

Who is you current commercial insurance company? 
Who is you current bond / fidelity company? 
Who is you current auto insurance company? 

Who is you current medical insurance company?  GroupIndividual

Do you need special proof of insurance SR-22 SR-1P