Gamboa & Morton
Insurance Agency
Commercial Insurance
Quote Request Form
CALL US or File out this form:
California Insurance License # 0656933 ***
Tel: (415) 282-5888   ---   Fax: (415) 282-3256
National Toll Free # 1-877-77-222-66
for California Residents & International Tourists
Let us help you with our expert knowledge & experience!



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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?  No Yes If yes, when?
  Product(s):                                                 mm/dd/yyyy                       
  Are you currently or previously insured with us? No Yes   
  
Select All Bond and Insurance Product(s) previously purchased through us:

 
Business Name:  

  
Applicant
 Mr. Mrs. Miss Ms.

 First Name: Middle Name: Last Name:

III, Jr.

EMAIL ADDRESS:

NATION: USA Canada Mexico

COUNTY/PARISH:
Other 
  Telephone Numbers:
Home: Work: Fax:
  Address Line 1:

Street #: 

Street Name:

Suite or PO #:
  Address Line 2:

City:

State/Province:

Zip Code:

Zip Code +4:
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 sub-contract.

Do you currently have commercial insurance? YesNo
Who is your current commercial insurance company?
 
Expiration Date:
Who is your current bond / fidelity company? 
Expiration Date:

Who is your current auto insurance company? 
Expiration Date:
Who is you current medical insurance company? 
Group orIndividual  ~~  Expiration Date:


 SIC Code (if known)

 Enter Business type here:
 Or pick one from the list BELOW:

Select by first letter of the business type or category:

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S T U V W X Y Z
Sample List of Businesses
A.     

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
B.     
Bakery / Pastry Shop Barber / Beauty Shop

Beauty Shop
Billiard Parlors Book Stores  
C.     
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
 D.     

Department Stores

Door & Window Installation

Dry Cleaners & Laundries
 E.     

Electricians

Electronic Stores: TV's, Radios, etc.
 F.     
Fabric Stores Fence Repair & Installation
Florists Food & Beverage Stores
Furniture Stores Full Service Car Wash
  G.     
Gardeners Gas Service Station Glass Merchants & Glaziers 
Golf Shops Grocery Stores  
 H.     

Hardware Stores

Hotel / Motel
 I.     

Ice Cream Parlors

Insurance Agencies
 J.     
Janitorial Services

Jewelry Stores & Watch Repair

Junior / Mini Markets
 L.
Laundries & Dry Cleaners Liquor Stores
 M.     

Mail / Office Centers

Markets

Mini-Shopping Centers

Motel / Hotel

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

Musical Instruments
 N.     

Night Club

Nurseries (botanical)
 O.

Offices

Office / Mail Centers
 P.     

Paint & Wallpaper Sales

Painters

Pastry Shop

Pawn Shops

Pet Supply Stores

Photo Studio

Photo Developers

Photo Suppliers

Plumbers

Printers
   
 R.     

Rental - Video

Repair Shop

Restaurants

Retail Stores

Rug Sales
 S.     

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  
 T.     

Tailor & Alteration Shops

Telecommunications or Video Cable Plant Installation ServicesTrophy Sales

Trophy Sales
 U.

Upholstery Shops - Auto

Upholstery Shops - Furniture
 V.     
Video & Pinball Arcades Video Cable Plant Installation Services or Telecommunications Video Rental & Sales Stores
 W.     
Watch Repair
 Y.     
Yogurt Shops