Transportation Insurance Quoting Information Step 1 of 9 - Basic Information 0% HiddenSalesperson InsuredEntity TypeClick here to select an optionIndividualCorporationLimited Liability Comanpy (LLC)Joint VenturePartnershipDOT Number The "DOT Number" issued by the Federal Motor Carrier Safety AdministrationInsured Name (Entity) Doing Business As ("DBA") Owner's Name Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Business Garaging Address (If Applicable) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Insured Contact InfoName First Last PhoneEmail OperationsData Sharing Options None ELD Only (Save $300/vehicle) Dash Camera (+$300/vehicle) Has your prior insurance ever been cancelled or non-renewed by any insurer in the past 3 years (for any reasons NOT related to payment of premium) Yes No Any bankruptcies (Chapter 11, 7, or 13) in the past 5 years? Yes No Time operating in your name (# Years + # of additional months) Additional Months Best description of your operation - Choose any that apply: Local Trucker Intermediate Trucker Long Haul Trucker Intermodal or Port Hot Shot Dump Trucks (Other) Dump Trucks (Sand and Gravel) End Dumper Units Logging Refrigerated Trailer Oversized or Overweight Automobile Hauler Household Goods Mover Tankers UIIA - Intermodal Towing Taxi / Limousine Service Cement Mixer Other (Enter Below) Best Description of your operation (Other) Will there be any personal use of any vehicle(s)? Yes No RadiusEnter the percentage of your hauls that fall in to each distance range for the fields below.% of Hauls up to 50 Miles (Please enter a number from 0 to 100) % of Hauls 51-200 Miles (Please enter a number from 0 to 100) % of Hauls 201-500 Miles (Please enter a number from 0 to 100) % of Hauls over 500 Miles (Please enter a number from 0 to 100) CargoUse the 'Add Cargo' button below to add all of your cargo types to the list below.Value of Limit-Motor Truck CargoClick here to select an optionNo, Excluded$100,000$125,000$150,000$175,000$200,000$250,000Cargo Cargo Percent of Total Cargo (Enter a number from 1 to 100) Actions Edit Delete There are no Cargos. Add Cargo Maximum number of cargos reached. Refrigeration Yes Refrigerated Goods Hauled No Refrigerated Goods Hauled TerminalsUse the 'Add Terminal' button below to add all of your terminals to the list below.Terminals Terminal Address Actions Edit Delete There are no Terminals. Add Terminal Maximum number of terminals reached. VehiclesUse the 'Add Vehicle' button below to add all of your vehicles to the list below.Vehicles Vehicle VIN Year Make or Manufacturer Model Value $ Class Body Type Actions Edit Delete There are no Vehicles. Add Vehicle Maximum number of vehicles reached. TrailersUse the 'Add Trailer' button below to add all of your trailers to the list below.Trailers Trailer VIN Year Make or Manufacturer Model Value $ Body Type Actions Edit Delete There are no Trailers. Add Trailer Maximum number of trailers reached. DriversUse the 'Add Driver' button below to add all of your drivers to the list below.Drivers Driver Name License State License Number Driver Date of Birth Driver Date of Hire Experience on Equipment (# of years + # of additional months) Additional Months Driver Eligibility Number of Accidents Number of Violations Number of Suspensions Number of Major Violations Actions Edit Delete There are no Drivers. Add Driver Maximum number of drivers reached. To expedite your Proposal, we need the following:Loss History for the Past Five Years*Max. file size: 128 MB.*We need this to provide discounts, and for Underwriting approval. Claims History – aka “loss runs” are ordered by you from your current Agent and/or Insurance Company. It is a good business practice to order these yearly. Loss History is only provided to Owner / Property Manager, we do not have access or authority to request.Copy of your IFTA reportMax. file size: 128 MB.Copies of your Commercial Auto, General Liability and Umbrella Coverages, if any.Max. file size: 128 MB.Consent(Required) I Agree to the Privacy Policy, Terms of Service, and Agree to Receive Communications.CommentsThis field is for validation purposes and should be left unchanged. Δ