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The worker comp insurance leads program designed for south Florida
Independent Insurance Agents and Captive Insurance Agents
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The City Insurance Agents Lead Buying Advantage
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Florida Worker Compensation Insurance
Lead Information Example
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Business_Name: Smith Company
Address: 5585 SW 10th Avenue
City: Fort Lauderdale
Zip_Code: 33310
Contact_Name: Bob Smith
Phone: 305-555-4444
Extension#: 55
Fax: 305-555-4545
Years_in_Business: 19
Contact_Email: bobs@yahoo55.com
Fed_ID: 525288994
Description_Operations_SIC: construction
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Full_Time_Employees: 15
Part_Time_Employees: 12
locations: 1
annual_Payroll: 1,300,000
Work_above_15_feet: yes
Use_Subcontractors: yes
Pre-employment_physicals: yes
Offer_safety_incentive_programs: yes
Current_Insurance_Co: Zurich
Current_Policy: ZX555555-55
Insurance_Expiration: 9/5/09
Other_Insurance_Company: Westchester United
3_yrs_Losses: yes
Amount_paid_for_each_loss: $5,000 & $7,000
Description_of_Losses: construction failure & truck hit building
Description_of_losses_or_loss_runs: employee fell off a scafold
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Contact Information
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Employee1_Class_Code: 7371
Employee1_Payroll: 35,000
Employee2_Class_Code: 8810
Employee2_Payroll: 950,000
Employee3_Class_Code: 9079
Employee3_Payroll: 400,000
Principal1_name: Bob Smith
Principal1_title: owner
Include1: yes
Principal2_name: Charles Migee
Principal2_title: manager
Include2: yes
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Employee Information
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