D & O “Quick Quote” Form

Complete the form below and we’ll send you a “quick quote” on a new Directors & Officers Liability policy. Questions? Email Peter Andrew, CEO, Council Services Plus, at pandrew@councilservicesplus.com or call (800) 515-5012 x 125.
Basic Information

Primary Contact

Liability Information

Annual Payroll: Annual Revenues: Total Assets: Total Expenses: Total Liabilities:

Retirement Plan Information