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Product Liability Insurance

Please provide your basic business information to get the quoting process started.

This will allow us to identify the proper insurance solutions for your business operations.

Business Information

Company Name *

Business Address *

City *

State *

Zip Code *

Type of Business Entity: *

If Other, Please Describe

Products Sold Info

Please Tell Us About Your Products And Goods Sold: *

Do Any Products Or Ingredients Or Components Originate From Outside Of The United States? *

If Yes, Please Provide The Country(ies), And the Name(s) Of The Manufacturer, Distributor Or Supplier

Do You Manufacture, Assemble, Package Or Install Products For Others To Be Sold Under Their Own Name Or Label? *

If Yes, Please Describe Business Operation.

Do You Have A Quality Control And Testing Procedure? *

Products Sold Info Cont.

Do All Records Show To Whom And The Date Each Product Was Sold?

Who Designs Your Products?

Are Product Designs Reviewed, Tested And Verified By Others?

Please Select OneHas Any Claim For Product Liability Been Made Against You Within The Last 5 Years?

Have You Ever Recalled Or Is It Considering Recalling Any Product?

Proposed Policy Effective Date *

Contact Info

First Name *

Phone *

Email *

Last Name *

Insurance Unlimited, LLC

(954) 634-7283

1500 Weston Road, Suite 200

Weston, FL 33326

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