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IOA Quick Facts

  • Florida’s Largest Privately Owned Insurance Agency
  • The Nation’s 8th Largest Privately Owned Agency – Insurance Journal
  • The Nation’s 27th Largest Insurance Broker Overall – Business Insurance Magazine
  • Florida’s Best Companies to Work For – Florida Trend
  • Top 100 Businesses – Orlando Sentinel
  • Best Places to Work – Orlando Business Journal
  • 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:
    $
     
     
    Send my quotation via: E-Mail Fax
    Regular Mail

     
    Thank you for filling out this form COMPLETELY!

    We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

    Yes, I Agree. Please Send Me a
    Workers Compensation Quote NOW!


    Click Button Below When Done

    Please Click Only Once . . . May take up to 30 seconds!



    Florida Commercial Insurance (An Affiliate of Insurance Office of America)
    4915 West Cypress Street | Tampa, FL 33607 | Phone: 813-262-2303 | Fax: 813-637-8484
    Email: bruce.johnson@ioausa.com | Florida Insurance License #: A132126