Home Page Home Page Pay Your Bills Helpful Links Contact Us View Our Locations Claims FAQ

General Liability Quote Form


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Company Information
Company Name
Required
Street
Required
City
Required
State
Required
ZIP / Postal Code
Required
E-Mail Address
Required
Primary Phone Number
Required
Alternate Phone Number
Optional
Company Owner
First Name
Required
Last Name
Required
Nature of Business
Optional
Number of Owners
Optional
Gross Annual Sales
Optional
Number of Employees
Optional
Annual Employee Payroll
Optional
Subcontractors Used
Optional
Annual Cost of Subcontractors
Optional
Square Footage of Location
Optional
Additional Information
Prior Insurance
Optional
Length of Coverage (Months and Years)
Optional
How many additional insureds are required?
Optional
How did you hear about us?
Optional
I understand that coverage cannot be bound or altered by this submission request until the information has been specifically confirmed by a Liebler Agency representative by phone or email.
Required
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
We're Now Mobile
GET A QUOTE
ABOUT US
COMPANIES REPRESENTED
LATEST AGENCY NEWS
BLOG
LET US KNOW HOW
WE ARE DOING

Marlette Office
3521 VanDyke Road, Suite B
Marlette, MI 48453
PH: 989-635-6800 or
888-455-9922
North Branch
3789 Huron Street
North Branch, MI 48461
PH: 810-688-3077 or
888-689-9915
Brown City
4232 Main Street
Brown City, MI 48416
PH: 810-346-2738 or
800-242-5645
Yale
100 S. Main Street
Yale, MI 48097
PH: 810-387-4214 or
800-530-7499
Imlay City
172 N Cedar Street
Imlay City, MI 48444
PH: 810-724-8600 or
866-724-8979
Powered by Insurance Website Builder