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Food Truck Insurance Quote Form
All information is kept strictly confidential and used ONLY to prepare an accurate quote for you
13
Questions
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1
Name of your business?
If you're using a business entity, please include full entity name & dba if applicable
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2
And what is your name?
First Name
Last Name
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3
Thanks {contactname:first}, and is {businessname} a new or existing business?
New
Existing
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4
Years in business?
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5
Average days in operation per week
if you're a new business, please enter what you anticipate
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6
Please describe your typical days and hours worked per week
e.g. Friday through Sunday, 8 hours per day
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7
Number of sites per day?
if you're a new business, please enter what you anticipate
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8
Estimated gross annual revenue/sales?
if you're a new business, please enter what you anticipate
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9
What kind of food do you sell out of your truck? Please briefly describe
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10
Thanks {contactname:first}. And what is the mailing address of {businessname}?
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11
Your email address?
please note: your information is kept private & used only to communicate with you regarding your insurance
example@example.com
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12
And what's the best phone number to reach you at?
please note: your information is kept private & used only to communicate with you regarding your insurance
Please enter a valid phone number.
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13
What's got you shopping for insurance today?
Select as many as you would like
Premium increase
Claims issues
Coverage concerns
Unsatisfied with current agent
Currently uninsured
Starting a new business
Other
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14
Agent Email
example@example.com
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