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Producer Appetite Survey
Please fill out the survey below if you would like to receive leads from the Liberty website.
Δ
Phone
This field is for validation purposes and should be left unchanged.
Email
(Required)
Name
(Required)
First
Last
Do you want to receive leads from the Liberty website?
(Required)
Yes
No
Appetite Information
Tell us what type of leads you want to receive.
Select your vertical(s)
(Required)
Personal Lines
Commercial Lines
Private Client
Employee Benefits
Which do you specialize in?
(Required)
Small group
Mid/large market
What personal coverages do you specialize in?
(Required)
ATV
Auto
Builders Risk
Classic Car
Comp Personal Liability
Condominium
Cyber
Dwelling Fire
Disability
Earthquake
Flood
Health Insurance
Homeowners
Homeowners (high net worth)
Inland Marine
Life
Motorcycle
Renters
RV
Snowmobile
Umbrella
Watercraft
Yacht or Large Watercraft
*Other
What other personal coverages do you write?
(Required)
Which 1-3 commercial industries do you specialize in?
(Required)
Accountants / CPAs
Agriculture
Auto Dealerships
Automotive & Overlanding
Automotive Service & Repair
Behavioral Health (ABA)
Cannabis
Childcare Services
Co-Brokers
Construction
Contractors
Cyber
Dental Practices
Drug & Rehab Centers
Energy & Utilities
Farm & Agriculture
Film, Event Production & Equipment Rental Houses
Film, Production & D.I.C.E. Coverage
Financial Services
Food & Beverage
Habitational
Healthcare Services
Landscaping
Lawyers & Lawfirms
Live Event & Film Contractors
Manufacturing
Medical Spas
Motorcycle Ride Group Chapters
Non-Profits
Ocean Marine
Plastic Surgeons & Surgery Centers
Professional Services (Lawyers, CPAs, Architects, etc.)
Property Developers
Property Management Companies
Property Owners/Landlords
Restaurants
Retail & Apparel
Security Services
Staffing Agencies
Technology
Tire Dealerships
Transportation
Trucking
*Other
What other commercial industries do you specialize in?
(Required)
Which state(s) are you licensed in?
(Required)
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Select All
Qualified Lead Criteria
Tell us what you need to know about a lead in order to determine if they are qualified
How do you determine if a Personal Lines/Private Client lead is qualified?
(Required)
Asset/property value
*Other
How do you determine if a Commercial Lines lead is qualified?
(Required)
Asset/property value
Company employee count
Company revenue
*Other
How do you determine if an EB lead is qualified?
(Required)
Number of lives
Group size
Funding type (self vs. fully)
*Other
Target asset/property value
(Required)
Under $250,000
$250,000 – $500,000
$500,000 – $1 million
$1 million – $5 million
$5 million – $10 million
Over $10 million
Target company revenue
(Required)
Under $1 million
$1 million – $5 million
$5 million – $10 million
$10 million – $25 million
$25 million – $50 million
Over $50 million
Target company employee count range
(Required)
1–10 employees
11–25 employees
26–50 employees
51–100 employees
101–250 employees
251–500 employees
501–1,000 employees
Over 1,000 employees
Target number of lives
(Required)
1–10 lives
11–25 lives
26–50 lives
51–100 lives
101–250 lives
251–500 lives
Over 500 lives
Target group size
(Required)
Individuals
Small group (2–50)
Mid-size group (51–250)
Large group (251–1,000)
Enterprise group (1,001+)
Target funding type
(Required)
Fully insured
Level-funded
Self-funded
Captive
Association plan
Other / depends on client
How else can we determine if a lead is qualified?
Please indicate if criteria only applies to certain types of coverages
HubSpot Information
To receive leads from the Liberty website you must be trained on HubSpot
Have you already been trained on HubSpot?
(Required)
Yes
Yes, Refresher Needed
No
Would you like a Digital Business Card page?
Example:
https://libertycompany.com/kirk-aguilera
Yes
No
Producer Consent
I understand that completing this survey does not guarantee that I will receive leads, or that all leads that I do receive will meet all of my listed criteria