Association Agency Inc.

New Jersey Worker's Compensation Premium Indication

Note: This is an estimated premium calculator.  Final premiums can not be guaranteed to the exact dollar.
Agent Name: Association Agency, Inc. Phone: 201-945-3100
2185 Lemoine Ave, Ste 1O Fax: 201-482-4564
Fort Lee, NJ 07024

 

Insured Name: $$$Input Company Name$$$
Insured Address: $$$Input Company Address$$$

 

Policy Effective Date: dd/mm/yyyy Policy Expiration Date: dd/mm/yyyy
Bodily Injury by Accident: $1.000.000 each accident
Bodily Injury by Accident: $1.000.000 policy limit
Bodily Injury by Accident: $1.000.000 each employee

 

Class Code Classificat
ion		 Annual
Payroll		 Rate Premium
9079 Restaurant Restaurant $$$Input$ 13.25 $
8810 Clerical Clerical $$$Input$ 2.9 $
7380 Drivers Drivers $$$Input$ $
$
$
TOTAL $ Estimated Premium $  
Pizza Trade Association CCV B INC LIMIT $
EXPERIENCE MOD $
MANAGE CARE CREDIT $
Schedule Credit Debit $
STANDARD PREMIUM $
PREMIUM DISCOUNT $
TERRORISM CHARGE $
EXPENSE CONSTANT $
Total Estimated Premium
NJ Second Injury
NJ Unemployment
TOTAL ESTIMATED POLICY PREMIUM

 

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