Castillo Associates.com - Free Arizona Workers Comp insurance quotes online. Fast AZ Workers Compensation insurance quote for Arizona residents

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Castillo & Associates
American Financial
Strategies Group, Inc.
2448 East 6th Street
Tucson, AZ 85719
Toll Free: 800-580-6855
Phone: 520-323-0220
Fax: 520-323-0223

E-Mail us at:
quotes@castillo
associates.com

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For Quotes, Complete Simple Online Form Below, or Call:

On-Line Workers Comp Insurance 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 Arizona)
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.)

FEIN or Social Security #: (now required by all comp carriers to quote)


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:	$


Send my quotation via:	E-Mail Fax Regular Mail

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