Workers’ Comp Quote

GET A FREE WORKERS' COMP QUOTE			Retail Council of New York State 258 State Street Albany, NY 12210 (800) 442-3589 (518) 465-3586 (518) 465-7960 fax www.retailcouncilnys.com
			Quote subject to NYSIF underwriting approval. Safety Group 493 Workers' Compensation Insurance is available only to members in good standing of the Retail Council of New York State. We value your input as PRIVATE information. Every step has been taken to insure your privacy and security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. Must be a NY retail business.

*Contact:
*Business Name:
*Address:
*City:
*State:
*Zip Code:
*Phone:
*Fax:
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In order to generate a workers' comp quote, we need your classification code(s) and estimated payroll. You can find this information on the declaration page you received with your most recent policy renewal. The declaration page of your workers’ compensation insurance policy specifies how your annual premium and renewal deposit is calculated. View a sample declaration page here.
	Code	Estimated Payroll
View common classification codes list here		$ (enter decimals and not commas, i.e., 100000.00)
		$	When you click "submit" you will see an estimated workers' comp quote on your screen. You will receive a follow up call from a Retail Council insurances services team member within 24 hours. Call (800) 442-3589 for more information about your workers' comp quote.
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