Tow Truck / Garage Insurance Quick Quote Application
It only takes 5 minutes to complete. We promise to never sell your information.
Select your Agent
Please Select
Ruth Bush
Kendra LaFrance
Company Name
Owner Name
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Tax ID# or SS#
Garaging Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the mailing address the same as the physical address?
Yes
No
Mailing address if different than garaging:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How many years have you been in business? If a new venture, state New.
How many years experience do you have in the towing or garage business?
Auto Liability Limit (Pick One)
$1 Million
$750,000
$500,000
$300,000
Other
Physical Damage Deductible (Comp/Collision)
$1000
$2500
$5000
Other
Garage Liability Limit (Pick One)
$1 Million
$750,000
$500,000
$300,000
Other
Garage Keepers Limit (Pick One)
$50,000
$100,000
$250,000
Other
Garage Keepers (physical damage for customer's vehicles in your care, custody, and control). Which one do you carry?
Legal Liability Basis (GKLL)
Direct Primary Basis (GKDP))
Not Sure
On-Hook Limit (Pick One)
$25,000
$50,000
$100,000
Other
Garage Keepers Values - Per Location
*
Dealers Open Lot (Comp/Collision - Owned Vehicles) - Per Location
*
Dealers Open Lot - Avg/Max Values
*
Has your insurance ever cancelled or non-renewed?
Yes
No
What is your estimated Annual Gross Receipts for all your operations?
Yes
No
What is your AVERAGE RADIUS of operation?
Please Select
0-50 Miles
50-100 Miles
100+ Miles
Which operations are you engaged in?
Towing & Storage
Repair Shop/Body Shop
Used Car Sales
SCHEDULED DRIVERS / EMPLOYEES
*
Who is your current Insurance Company?
Have you had any losses or claims in the last 5 years?
Yes
No
What is your Estimated Total Annual Premium ($)?
How did you hear about us?
Please Select
Ruth Bush
Upload insurance documents, declaration pages from current policies, LOSS RUNS, or supporting documents that might help us to communicate with underwriters.
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What is your effective date of coverage?
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Month
-
Day
Year
Date
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