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Trucking Simplified

Information Request Form

Please provide the following documentation.

A current Acord insurance certificate showing limits for Truckers Auto Liability, General Liability, Cargo, Physical Damage, Trailer Interchange, etc.

Include Unit Type, Year, Make, Complete VIN # and Value (If Physical Damage is Required for Tractors and Trailers).

Include Full Name, Date of Birth, Date of Hire, License #, State and Years of Experience.

Current year, plus at least two full prior years for renewing coverages. Insurance carriers require loss runs to be valued within the last 90 days – however provide most current available for immediate.

IRP-schedule B reports, mileage by state for the most recent four quarters.