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HANN LOGO Workers Compensation Insurance
Quote Sheet
CALIFORNIA ONLY

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FILL OUT THE BELOW FOR A
WORKERS COMPENSATION INSURANCE QUOTE
workers compensation insurance
Business Name:
Number of Owners:
Owners Name(s):
No. of Employees:
Payroll:
Years in Business:
Type of Business:
How many years with prior insurance company:
Current Carrier:
workers compensation insurance

Information Needed For Reply
Email:
Name:
Address:
City:
State:
Zip:
Phone: -
Fax: -  * Not Required
How did you find our web site ?  * Not Required
Any Further Questions:

If something is not listed here, or you have any questions about
your coverages, or need to know how to answer a question, E-mail us at

mail@hanninsurance.com
Or call our direct telephone line at (760) 365-9744.

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Disclaimer: All quotes are subject to change. Quotes are based on the information
you provide. Please be as accurate as possible so we can be as accurate as we can.

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