Commercial Auto Insurance

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Insured’s Name

Insured’s Phone Number

Business Name

Business Type

Business Location

Mailing Address

Years of Experience

Years of Business

License Number (DL): (MUST BE COMMERCIAL LICENSE- SCHEDULE A)

DOB

Garaging Address (if different)

VIN #

Year/Make/Model

Value of vehicle

DOT(Department of Transportation-if used to deliver)

Years of experience

Distance (how far they drive ex: 5-10, 10-20, 500 +miles)

Vehicle Liability Coverage ($1M liability if transporting Oil/ $5M Hazardous materials- $750K General if over 10K lbs/ $300K if under 10K lbs)

Cargo Coverages (100K, 300K, 500K, 1M)

Do they cross state lines?

Any Convictions in the last 3 years?

Need 3 years of Loss Report (Last insurance reporting any claims in the last 3 years)

(866) 577-4667