Workers’ Compensation Insurance with Al – The Lapointe Insurance Agency

Workers’ Compensation Insurance

We’ll need a few pieces of information! Fill out this quick questionnaire so we can find you the best value.

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 *

Al Robinson IV

arobinson@lapointeins.com
Office: 508-678-8341 x 307
Mobile: 401-632-5325