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Example Workers Compensation Lead

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MostChoice.com Lead
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Lead Type: Workers' Comp
Date: 6/1/2002
 
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BUYER INFORMATION
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Name: Betty Customer
Title: Accountant/Controller
Company: Zakhem Investment America
Company Size: 1-9
Industry Type: Real Estate
Address: 5615 Richmond Ave, Ste 200
Location: Houston, Texas 77057
Phone number: 713-266-1111
Email: bettycus@yahoo.com
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KEY REQUIREMENTS
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Does user currently have workers' compensation? No
If yes, their current carrier:
Approximate total amount of workers' comp claims paid within the last three
years: 0
Timeframe for when user would like plan to take effect: ASAP
User's NCCI experience modification factor: N/A
Does user offer a health plan to employees: Yes
User's most recent calendar year gross payroll: Under $100,000
Number of employees user would like to cover: 2-4
Does user have employees who live outside of their business's state: No
User's desired liability limit for employees: $500,000
Job function(s) of user's employees: 3 office workers
1 maintenance worker
User's business entity: Corporation
Number of years that the company has been in business: 17
Business Description: investment
Owner's years of experience: 7
User's ZIP code: 77057
Additional requirements:


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