AMIS/Alliance Marketing & Insurance Services, LLC
(800) 843-8550 (760) 471-7116
7am - 4pm Pacific Time (PT) Monday - Friday

Insurance Quick Quote

Alarms Systems & Installation, Burglary Alarms, Electronic Security, and Safety Equipment

Business & Contact Information
NOTE: Business address must be a street address - NO PO BOXES.
If both addresses are the same, please leave blank.
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Information About Your Business
Selecting "Yes" will reveal additional fields below.
Selecting "Yes" will reveal additional fields below.
Employment / Training
Pre-Employment Screening Procedure (check all applicable)
Training Program Consists Of (check all applicable)
Operations
Percentage of Operations

Please enter the percentage for each activity.

Total must equal 100%
Operation Total:
0%
%
%
%
Selecting "Yes" will reveal an additional field below.
Selecting "Yes" will reveal an additional field below.
Payroll / Receipts
Payroll & Receipts Breakdown
Installation
Manufacturing
Sales / Dist.
Service
Other
Payroll $
Receipts $
Payroll / Subcontractor's Costs / Monitoring
$
$
$
Selecting "Yes" will reveal additional fields below.
Selecting "No" will reveal additional fields below.
Subcontractors (Other Than Monitoring)
Selecting "Yes" will reveal additional fields below.
Products Sold
Selecting "Yes" will reveal additional fields below.
Client Percentages
Client Base Breakdown
Client Category
% New Construction
% Rehab / Retrofit / Service
Row Totals
Apartments
% New Construction
%
% Rehab / Retrofit
%
0%
Commercial
% New Construction
%
% Rehab / Retrofit
%
0%
Condos
% New Construction
%
% Rehab / Retrofit
%
0%
Custom Houses
% New Construction
%
% Rehab / Retrofit
%
0%
Industrial
% New Construction
%
% Rehab / Retrofit
%
0%
Institutional
% New Construction
%
% Rehab / Retrofit
%
0%
Single Family
% New Construction
%
% Rehab / Retrofit
%
0%
Track Housing
% New Construction
%
% Rehab / Retrofit
%
0%
Work for Builder (Condos, Homes, etc.)
% New Construction
%
% Rehab / Retrofit
%
0%
Subtotals
New Construction
0%
Rehab / Retrofit
0%
Grand Total
0%
Gross Receipts
Operational Breakdown (Gross Receipts)
Operation
$ Sales / Install / Svc
$ Monitoring
Row Totals
Burglary (Perimeter / Internal / Motion)
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Carbon Monoxide Detection
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Central Vacuum
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Closed Circuit TV
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Fire / Smoke / Heat Detection
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Home Theater
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Intercom
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Medical Emergency Pendants
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Medication Reminder Service
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Personal Emergency / Panic Button
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Preconstruction Wiring / Conduit
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Temperature Control
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Utility Monitors (HVAC / Water / Gas)
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Water Flow on Sprinkler System
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Other
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Other
$ Sales / Install / Svc
$
$ Monitoring
$
$0
Subtotals
Sales / Install / Svc
$0
Monitoring
$0
Grand Total
$0
Desired Terms for Quote
/ /
(Month / Day / Year)
Limits of Liability
Deductible
Current Insurance Information
Selecting "Yes" will reveal additional fields below.
Selecting "Yes" will reveal additional fields below.
Licensed Agent / Broker Information
Selecting "Yes" will reveal additional fields below.
Comments & Priority
Maximum 200 characters
Declarations and Legal Notices

Terms of Use & Declaration:

By submitting this quick quote application, you declare that:

  • the information you are providing is accurate and complete to the best of your knowledge and belief
  • you have read and agree to our underwriting conditions
  • you have read and agree to our Fraudulent Acts Notice
  • you have read and agree to our California Notice (CA businesses only)
  • you have reviewed and confirm as true, correct and complete each of the representations and warranties and all other information set forth in the application.

AMIS/Alliance Marketing & Insurance Services does not warrant or guarantee suitability or adequacy of coverage in meeting any generic, specific or contractual requirements of any insurance company, state, county, corporation, public entity, or public party that you may provide services to during the policy period, including any written or oral request forwarded to AMIS or its staff. You assume the risk of obtaining suitable or adequate coverage to meet any generic, specific or contractual requirements of your client or company. The information contained herein is provided with the understanding the AMIS is not engaged in rendering legal services, including legal opinions or advice, or professional risk management consulting. If legal services or professional services are required, you will need to seek the advice of legal counsel.

NOTE: An application or information form is not an insurance policy and does not bind any coverage. All applications must be underwritten and a quotation will be issued subject to underwriting guidelines. The quotation does not bind coverage.
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