New Jersey insurance from The Fig Leaf Insurance Agency
The Fig Leaf Agency is New Jersey's Insurance Warehouse! FAST & FREE Quotes Online.
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Personal Auto, Homeowners Insurance for New Jersey from the Fig Leaf Insurance Agency
Personal Auto Insurance

Homeowners Insurance

Boat Insurance

Personal Umbrella

Life Insurance

Health Insurance


Commercial and Business Insurance from the Fig Leaf Insurance Agency
Business Owners Insurance

Commercial Auto Insurance

Workers Comp Insurance

General Liability Insurance

Commercial Umbrella


Other Insurance Services from the Fig Leaf Insurance Agency
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Online Workers
Compensation 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 New Jersey!
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.)
 

 
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: 		$
 
 
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The Fig Leaf Insurance Agency . 1043 Raritan Road . Clark, NJ 07066
Toll Free Phone: 1-877-984-3344 . Phone: 1-732-388-FIGS . Fax: 1-732-388-1187
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