1233 N Mayfair Rd # 104, Milwaukee, WI
Phone: (414) 453-6181 – Fax: (414) 453-0080 – agents@macgillisandcompany.com

Business Insurance

We work closely with many insurance companies to offer you the best coverage for the best price. Use our Quote Form below to get your insurance quote today or call us and we will be glad to discuss your particular needs.

Contact Information

Name:
Phone Number:
Email:
Preferred Method of Contact:
Preferred Time of Day to Call:
Question/Comment:

Business

Name of Business:
Type of business (work done):
Organization:
FEIN Number:

Property

Building Values:
Business Personal Property Values:
General Liability Limits:

Workers Compensation

Limits:
1 2 3

Class Code:
Payroll:
Individuals:
Name

Individual 1:
Individual 2:

Business Auto

Year Make Model Vehicle Identification Number

Vehicle 1:
Vehicle 2:
Vehicle 3:
Garaging Address:
Limits of Liability:
UM/UIM:
Medical Payments:
Comprehensive Deductible:
Collision Deductible:
(Please email additional vehicle information if applicable)

Umbrella

Liability Limit:

Anti-Spam Question:
(Required) Is water wet or dry?

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