Zavagn 440-884-2530, Pavarini 216-374-4500

Childcare Business Insurance

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

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City

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State

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ZIP / Postal Code

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Primary Phone Number

Required

Alternate Phone Number

Optional

E-Mail Address

Required

Business Type

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Company Owner

First Name

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Last Name

Required

Gross Annual Sales

Optional

List all locations you offer childcare

Required

How long in business?

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How many years experience in this field?

Required

Prior Insurance

Optional

Length of Coverage (Months and Years)

Optional

Expiration Date

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Describe any claims, lawsuits, administrative actions

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Number of Owners

Optional

“Employees” include: Sole proprietor, Partner, Executive Officers, Seasonal employees, Part-time employees, Full-time employees.

Number of Full Time Employees

Required

Number of Part Time Employees

Optional

Annual Employee Payroll

Optional

Number of Full Time Volunteers

Optional

Number of Part Time Volunteers

Optional

Please explain pre-employment screening requirements

Required

Credentialing - Is center

Required

How many children is applicant licensed to care for?

Required

Any past losses, claims, allegations, lawsuits, or administrative actions relating to sexual abuse or molestation allegations, discrimination, or negligent hiring by any owner, employee, client, parent or volunteer?

Optional

Do you need pricing on commercial auto, buildings, business property?

Required

Do you need pricing on a surety bond?

Required

How did you hear about us?

Optional

Full Name of Person Entering Application

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Submission Validation

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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.

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Zavagno 440-884-2530 and Pavarini 216-374-4500