Frost Insurance Agency now offers PACMA members a new Commercial Package
that includes general liability, property, auto, umbrella, and inland marine
coverage through a selection of A+ rated carriers. In addition to these
specially negotiated services, Frost Insurance Agency is offering claims
management, online safety training information, OSHA reporting and updates,
employee handbooks and industry-related news. As an extra benefit to members and
their employees, Frost Insurance Agency has a new Personal Lines Program that
includes auto, home, RV and boat coverage at discounted rates. The Workers
Compensation and Commercial Package programs have already proven successful with
PACMA members, with one member saving more than 35%. To take advantage of these
savings, please call Shanan Wagoner at (800) 259-7196; or to receive a quote
through any of the new programs, please complete the Quick Quote Application
Form and fax to Shanan Wagoner at (210) 220-6460.
Worker’s
Compensation Quote Application
Mailing
Address, City, Zip: ______________________________________________
Years
In Business: __________________ Phone/Fax Number: _________________
Contact
Person: ________________________________________________________
Type
of Ownership: Partnership___Individual___Corporation___Other____
List
All Partners, Owners, or Corporate Officers who are to be excluded:
_______________________________________________________________________
Current
Carrier: ___________________________ Exp. Date: ______ Premium____
Location:
_______________________________________________________________
Address/Street
City
Zip
County
List
all accidents and cost of claims for three years, where an employee required Medical
Attention:_____________________________________________________________________
(Please
attach three years loss history.)
*
Are all of your operations within the state of Texas? _________________
*
Do all excluded officers own at least 35% of the business?
_______________
*
Is any work done above 2 stories? ____________________
*
Is any work done on the premises of refineries or energy produces?
___________
Fax form to 210-220-6460
Attn: PAMCA Frost Services: Or Email to: swagoner@frostinsurance.com.
If you have any questions please call: 1-800-259-7196 and ask for a PAMCA
Support Team member. (This form is
not to be used, copied or reproduced without the
express written consent of Frost Insurance)
To be removed from the fax list call: 713-461-6996.