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Trucking Insurance Quote

  1. Trucking Insurance Quote
Trucking Insurance QuoteJacob Menaker2023-06-13T10:32:15-07:00

"*" indicates required fields

1Basic Info
2Contact(s)
3Trucks & Trailers
4Drivers
5Commodities
6Additional Insureds
7Wrapping Up

Basic Information

Is your business currently insured?*
Current policy expiration date*
Is this a New Venture or was there a Lapse in Coverage?*
Desired Coverages*
(Select all that apply)
MM slash DD slash YYYY
Do you have a DOT#?*
Do you have an MC#?*
Do you have a Tax ID Number?*
How is the business structured?*
Has the business either Currently or Previously operated under a DBA?
Business Mailing Address*
Business Garaging Address
Are all vehicles garaged at the same location?*

Primary Contact

Name*
Date of Birth*
Can we text you?*
Consent is not required as a condition of purchase. Message frequency will vary. Message and data rates may apply. Reply HELP for help or STOP to cancel. Privacy Policy.
Designated Financial Responsibility for Company?*
What is your Role?*
  • Owner / Operator - Both a Manager and included on the policy as a Driver.
  • Manager - Strictly a manager, is NOT a Driver on the policy.
  • Other - Anyone besides the Owner / Management that has been authorized to contact us on their behalf, particularly to make modifications to their Policy / Coverages.
Is there a Secondary business contact?*

Secondary Contact

Secondary Contact: Name*
Secondary Contact: Date of Birth*
Secondary Contact: What is your Role?*
  • Owner / Operator - Both a Manager and included on the policy as a Driver.
  • Manager - Strictly a manager, is NOT a Driver on the policy.
  • Other - Anyone besides the Owner / Management that has been authorized to contact us on their behalf, particularly to make modifications to their Policy / Coverages.

Truck(s) Information

Do you have any trailers you want to insure?*

Trailer(s) Information

Driver(s)

Do you have additional drivers?

Commodities

What type(s) of commodities do you haul? The grand total of all commodities should equal 100%.
 
Add Commodity 2
 
Add Commodity 3
 
Add Commodity 4
 
Add Commodity 5
 
Add Commodity 6
 
Add Commodity 7
 
Add Commodity 8
 
Add Commodity 9
 
Add Commodity 10
 
This should equal 100%
If you haul other commodities not listed above, please enter them here.

Additional Insured(s)

Does anyone need to be listed as Additional Insured
If your AIs have documents or requirements you may upload those here.
Drop files here or
Accepted file types: pdf, Max. file size: 2 MB, Max. files: 10.
    Drop files here or
    Accepted file types: pdf, png, jpg, Max. file size: 2 MB.
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      Mint Insurance Agency

      Miramar Florida Office

      7951 Riviera Blvd.
      Suite 203,
      Miramar, Florida 33023
      Phone: 954-908-7951
      Fax: 866-457-9678

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