Co-Employment Pricing

---

CoEmployment Quote Inquiry

Step 1 of 3

33%

• Contact Information

• Assumed Business Name*
• Name*
  First Last
• Title
• Address
  Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code
• Preferred Method of Contact*
  • Email
  • Phone
  • Either
• Email*
• Phone*

• Job Information

• Work location*
  Where will work be performed?
• Specific work performed*
• Number of Employees
• Enrolling all of your staff?
  -YesNo
• Average hours per week
• Rate of pay*
• Duration of job
  Temporary (< 1 year)Ongoing

• How is payroll currently done?
  -Payroll ServiceBookkeeperCPAInternal StaffSelfNo Current Payroll
• Do you sponsor any group benefit plans?
  -YesNo
• Do you currently have Workers' Comp coverage?*
  -YesNo
• Are you a Contractor?*
  Construction and Landscape businesses, select Yes.
  -YesNo
• CCB/LCB Number*
• Anything else you'd like us to know?

• Referral Information

• How'd you hear about Cardinal?
  -Client/EmployeeOnline/AdStaff/CommunityOther
• Who can we Thank?
• CAPTCHA

---