LiveZilla Live Help

commercial insurance



Translate This Website

 

COMMERCIAL AUTO Insurance Quote Form

As a business owner, you need the same kind of insurance coverage for the vehicle you use in your business as you do for a vehicle for personal travel – liability, collision and comprehensive, medical payments (know as Personal Injury Protection) and coverage for uninsured/underinsured motorists. In fact, many business people use the same vehicle for both business and pleasure.

Whether you need to buy a business auto insurance policy will depend on the kind of driving that you do. We will ask you about your usage of the vehicle for business purposes, the individuals that will be driving them and whether employee's are likely to be driving their own cars for your business.

While the major coverage’s are the same, a commercial auto policy differs from a personal auto policy in many technical aspects. For more information, please feel free to contact us at 877-9-THE FIG. You can also complete the questionnaire below to be contacted by one of our agents.

YOUR PERSONAL DATA:

Your Name:
Business Name:
Street Address:
City:
State: MUST be New Jersey!
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If no, type NONE)
 
Type of Business:
(Please be specific, and
tell how vehicles are used.)


 
DRIVER INFORMATION #1
(if more than two drivers,
list in remarks)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Number & Type of
Accidents within
last 3 years:
Number & Type of
MINOR violations within
last 3 years:
Number & Type of
MAJOR violations within
last 3 years:
Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No Comments or
Remarks?
 
DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Number & Type of
Accidents within
last 3 years:
Number & Type of
MINOR violations within
last 3 years:
Number & Type of
MAJOR violations within
last 3 years:
Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No Comments or
Remarks?


COMMERCIAL VEHICLE #1:
If more than 2 vehicles, list in remarks
or call us at: 1-877-984-3344
Year of vehicle: Make & Model:
Type (truck, tow-truck, bobtail, etc.): Length in Feet:
Gross Vehicle Weight: Cost
New: $
Radius of operation: Value $:
List Special Equipment & Values
(i.e., rack, tool box, etc.)

VEHICLE ID#
(highly suggested for accurate rating)

VEHICLE #1 COVERAGES:
Limits of
Liability:
$500,000 CSL
$750,000 CSL
$1 Million CSL
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
COMMERCIAL VEHICLE #2:
Year of vehicle: Make & Model:
Type (truck, tow-truck, bobtail, etc.): Length in Feet:
Gross Vehicle Weight: Cost
New: $
Radius of operation: Value $:
List Special Equipment & Values
(i.e., rack, tool box, etc.)

VEHICLE ID#
(highly suggested for accurate rating)

VEHICLE #2 COVERAGES:
Limits of
Liability:
$500,000 CSL
$750,000 CSL
$1 Million CSL
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

 
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Commercial Vehicle Quote NOW!


Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!