Workers’ Compensation Insurance – Rick Lima – The Lapointe Insurance Agency

Worker’s Compensation Insurance

We’ll need a few pieces of information! Fill out this quick questionnaire so we can create a policy to match your needs.

Fields marked with an * are required

Name of Business *

Property Address *

City *

State *

Zip *

Is the property address the same as the mailing address? *

Mailing Address *

City *

State *

Zip *

Number of Employees? *

Job Title/Job Description *

What is the annual payroll for employees? *

FEIN Number *

Is the company owner an LLC?

Does the owner want to be excluded from coverage?

Contact Name *

Email *

Phone *

Rick Lima
Licensed in MA, RI, NH, CT, VT, and ME

rlima@lapointeins.com
Office: 508-678-8341 x 308
Mobile: 401-743-4353