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Home
About
Careers
Coverages
Auto Liability
Motor Truck Cargo
Physical Damage
Per Shipment Cargo
Occupational Accident
Workers’ Compensation
Partners
Resources
Blog
Starting A Trucking Company
Trucking Terms
Services
Portal Login
Claims Services
Request A COI
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Trucking Simplified
Information Request Form
Name of Company
DOT#
Years in Business
Owner
DOB
License #
Garaging Address
# of Trucks
# of Trailers
FED ID#/ EIN
Equipment Type(s):
Dry Van
Flatbed
Reefer
Auto Hauler
Other
Top 3 Types of Cargo
Please provide the following documentation.
Limits/Coverages Required
A current Acord insurance certificate showing limits for Truckers Auto Liability, General Liability, Cargo, Physical Damage, Trailer Interchange, etc.
Limits/Coverages Required
Equipment List
Include Unit Type, Year, Make, Complete VIN # and Value (If Physical Damage is Required for Tractors and Trailers).
Equipment List
Driver List
Include Full Name, Date of Birth, Date of Hire, License #, State and Years of Experience.
Driver List
Loss Runs
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.
Loss Runs
Mileage Reports
IRP-schedule B reports, mileage by state for the most recent four quarters.
Mileage Reports
Send