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Business Insurance Connections
One simple intake → multiple options from vetted commercial insurers. Fast, transparent, no pressure.
Legal Business Name
*
Operating Name (if different)
Your Name
*
Role/Title
Email address
*
Phone number
*
Website (if any)
Business Address
*
Business Structure
*
Select
Corporation
Sole Proprietor
Partnership
Non-profit
Years in Business
*
Primary Industry
*
Select
Contractor/Trades
Retail/Shop
Restaurant/Food
Professional Services
E-commerce/Wholesale
Transportation/Logistics
Real Estate/Landlord
Health/Beauty
Manufacturing/Fabrication
Other
If other describe industry
Describe your operations
*
Service Area
Please select at least one option.
Canada
Ontario, Canada
USA
International
Annual Gross Revenue (estimate)
*
Select
<$100k
$100–250k
$250–500k
$500k–$1M
$1–$2M
$2M+
Annual Payroll (estimate)
Select
<$100k
$100–250k
$250–500k
$500k+
Employees
Do you use subcontractors?
yes
No
Premises
*
Own
Lease
No Fixed premises
Location Address (if own or leased)
Square Footage
Construction Type
Select
Non-combustible
Combustible
Mixed
Sprinklers
Yes
No
What do you want quoted?
*
Please select at least one option.
Commercial General Liability (CGL)
Commercial Property
Business Interruption
Tools & Equipment
Commercial Auto
Professional Liability (E&O)
Cyber
Directors & Officers (D&O)
Product Liability
Cargo/Inland Marine
Builders Risk (Course of Construction)
Bonding/Surety
Preferred Liability Limit
$2M
$5M
Not sure
Deductible Comfort
Select
$500
$1,000
$2,500
Not sure
Current insurer
Renewal Date
Claims in the last 5 years?
*
Yes
No
If Yes: Dates, amounts, brief details
Any cancellation or non-renewal?
*
Yes
No
If Yes: Brief details
COI requirements (Additional Insured / Waiver of Subrogation, etc.)?
Best Contact Time
Select
Morning
Afternoon
Evening
Contact Method
Phone
SMS
Email
Consent to Connect
*
Please select at least one option.
I consent to Sharked Group sharing my intake with vetted insurance partners so they can contact me by phone, SMS, or email.
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