Consumers Insurance Group 101 Good Drive, P.O. Box 6425, Lancaster, PA 17607
(717)397-7531 * (800)795-7531
FAX (717)397-2296
info@consinsgrp.com		 Consumers Insurance Group
Hours: Monday-Thursday 8:30AM-6:00PM, Friday 8:30AM-5:00PM
 
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Please note that Consumers Insurance Group transacts business in Pennsylvania ONLY.

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General Information

Business Name:  

 *
Address:   *
 
City:  
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State:   

PA

Zip:   

*
Contact Name:   
*

Phone:  

 * (111-555-1212)
Email Address:    *
Description of Business:  

Estimated Annual Sales:   
 
Please list company vehicles with gross vehicle weight and cost new:
Vehicle GVW Cost New  
 
 
 
Please list company equipment and tools, including values:
 

Workers Compensation Information
Job Description/ Classification Code Payrolls

# Employees  

FT   PT  
 

 

 

 
 
Quote Information
Type of Policy Effective Date
(01/01/1980)		 Name of Current Carrier  
 
 
 
 
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Consumers Insurance Group, Inc is licensed to conduct business in Pennsylvania.  The information
on this site is a solicitation to conduct business only in the aforementioned state of authority.
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