"Over the past five years, The O'Neill Group has provided us with a professional service relationship and a unique sense of friendliness and compassion. They've understood the diverse environment of a charter school, in addition to realizing the financial constraints of a newly established entity. The O'Neill Group was not only very responsive in providing for our insurance needs; they offered it at a resonable cost" -Ron King, Business Manager, Eagle Heights Academy, Youngstown, OH

General Liability Quick Quote-
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General Information
School Name*
Contact Name*
Email Address*
Phone
Fax
Street Address
City
State	zip
Publicly Funded?	Yes No
Number of Students and Faculty
Do students play organized sports?	Yes No
If so, which sports
Is Day Care Provided?	Yes No
If yes, how many children?
Limits of Liability Requested:
Public Liability	$1,000,000 $2,000,000 $3,000,000
|
Commercial Automobile
Owned Vehicles?	Yes No
If yes,
Year, Make Model of vehicle
Vehicle Usage
Garage Location
Cost New
# of passengers
Leased or owned?
Driver(s):
Name Date of Birth Drivers License #
|
Umbrella Liability
Limits Requested	$1,000,000 $3,000,000
	$5,000,000 $10,000,000
	Other:
Quote Request Status:	Urgent
	Please respond within 30 days
	Please respond within 60 days
	General Inquiry, not an urgent matter
Additional Comments: