FAST and FREE Missouri and Kansas Contractor Insurance Quotes Online from!
Home   |   Contractor Quotes   |     Request Certificate   |     About Our Agency  |     Contact Us
click here for free contractor insurance report!
Get Our Free Report!
Your Name
Your Email
get a free contractor's insurance quote!
Contractor Insurance:

General Liability
Fast and Free Contractor Liability Insurance Quotes from
Vehicle Quotes
Fast and Free Contractor commercial vehicle Insurance Quotes
Workers Comp
Fast and Free MO and KS contractor workers comp Insurance Quotes
Tool Floater
Fast and Free Contractor Tool Floater and Inland Marine Insurance Quotes
Bond Quotes
Fast and Free Contractor Bond Quotes
Umbrella Quotes
Fast and Free Contractor Commercial Umbrella Liability Insurance Quotes
Builder's Risk
Fast and Free Contractor Builders Risk Insurance Quotes
Health Quotes
Fast and Free Contractor individual health Insurance from
Group Health
Fast and Free Contractor group health Insurance quotes from
Life Insurance
Fast and Free life Insurance Quotes
Income Quotes
Fast and Free disability Insurance Quotes

     •   Map/Office Directions
     •   More About Our Agency
     •   Our Privacy Notice

Website Design by:
Insurance-Web-Sales © 2014

On-Line Personal Health
Insurance Quotation Form

One Simple Form - takes only 2-3 Minutes!

Your Personal Data

Your Name:
Street Address:
Zip Code:
E-Mail again for accuracy:
Phone (if more info. needed):
Fax (optional):
Primary Insured's Occupation:
Marital Status:
Single Married
Male Female
Type of Health Insurance
you have currently?

Insured Name: Birthdate:
Insured Height: Insured Weight:
Spouse's Name: Spouse's Birthdate:
Spouse's Height: Spouse's Weight: (M/F):
Include Spouse?: Yes No Include    
Yes No
List children's names,
(first & last), their
relationship to you,
and birthdates:
(up to 6 children)
Name/Rel.:B-Date: M/F:
Name/Rel.:B-Date: M/F:
Name/Rel.:B-Date: M/F:
Name/Rel.:B-Date: M/F:
Name/Rel.:B-Date: M/F:
Name/Rel.:B-Date: M/F:
Be as specific as you can on the underwriting questions below so we may find the most competitive product for you!

Does any family member living in the household use or has used any tobacco products? (if yes give dates, and details in remarks section).
Yes   No

Describe usage (cigar,
cigarettes, etc, and how long.)

Any Pre-existing Health Conditions?
(If yes, descibe in detail, and to which of the insured persons they apply.)
Any Covered Persons Currently Taking Medication of Any Kind?
(If yes, descibe in detail, and to which of the insured persons they apply.)

Are You Looking for Coverage for more than 6 months?
What Deductible Are You Interested In?
($250, $500, $1000, $2000 etc.):
Any special coverages needed?
(Maternity, H.M.O., P.P.O., etc.)
If you're looking to reduce premium cost, and want information on the NEW HSA (Health Savings Plans), check the HSA box here and we'll include information. Please Include HSA Information
Tell Us What You Want MOST in your Health Plan, or list any other Remarks here:

Send my quotation via: E-Mail Fax
Regular Mail
Call me by Phone!

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me My
Health Insurance Quote NOW!

Help Us Fight SPAM! Please enter the code#
below in the box, to show you are human!

Reload Image

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

Jay P. Stoetzer Insurance
5750 W. 95th Street, Suite 105 | Overland Park, KS 66207
Toll-Free: 855-EZQUOTE
Local Phone: 913-221-7764 | Fax: 913-385-3500
About Our Agency | Privacy Notice | Office Map/Directions

Search terms used to find us on the internet include: Missouri contractor insurance, MO contractor insurance quotes, Missouri contractor general liability insurance, KS contractor and artisan general liability insurance quotes, Missouri contractor workers comp insurance, Kansas contractor workers comp, KS contractor bonds, MO contractor's insurance, low cost KS contractors liability insurance, cheap contractor liability insurance, Missouri carpentry liability insurance, MO landscapers general liability insurance, discount Kansas contractor insurance, Missouri and Kansas contractor insurance quotes online,Contractors, Contractor, Contractor insurance, Contractors insurance, Work comp, Contractors Work Comp, Contractor liability, Contractors liability, Plumber, Carpenter, Electrician, Painter, Handyman, General Contractor, Tract Home, Construction, Sub contractors, Framer, Framing, Foundation, Cement, Roofer, Roofing, Heating, Air Conditioning, HVAC, Contractor's insurance, Contractor PL & PD, Artisan liability insurance, Contractor general liability insurance.