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MOTOR TRUCK CARGO ONLINE QUOTE
Commodities
Does the Applicant Haul Household / Office Goods
Please select Class:
Agency Information
Agent Name:
Agency Name:
Agent Email Address: (A copy of the quote will be sent to this address)
Insured Information
Insured Name:
Insured Address:
Insured City:
Insured State:
Insured Zip:
Please choose a limit
Risk Information
Does Applicant Haul Oriental Rugs?
Does Applicant Haul Boats?
Does Applicant Haul Guns and Ammunition?
Does Applicant Haul Refrigerated Goods?
Does Applicant Haul Mobile Homes?
If yes to the above, does Applicant Haul Modular Homes?
Does Applicant Haul Livestock?
Is Applicant a Wrecker or do they Haul Autos?
If yes to the above, how many cars are they hauling at once?
Will Applicant Require Coverage on:
Is Risk a New Venture?
Does Applicant Haul Anything from the Following List:
Electronics (including computer hardware, software and parts, radios, stereo and television sets & parts, and cellular phones), auto parts / tires, pharmaceuticals, drugs, tobacco, copper and other precious metals and alloys, liquor (not beer or wine), cameras / photographic film supplies, furs / fur trimmed garments, wearing apparel, any type of silks, rayons or nylons, motorcycles, tarpaulin loads?
Risk Details
What is the Radius of Operations?
Number of Power Units:
Are Trailers Fully Enclosed?
Number of Losses in the Last 3 Years:
Has Any One Loss Been More Than $5,000?
Has insurance been canceled within the last 5 years?
Are filings required?
Physical Damage
Would the applicant like Physical Damage coverage? (Check if yes)
What is the Garaging City?
What is the Garaging State?
What is the Garaging Zip Code?
Number of Trailers: (Input Zero if Non-Applicable)
What is the value of all units?
Deductible:
Are any units high value or antiques?
Are any units older than 15 years?
Please note that all quotes are subject to acceptable MVRs. Drivers with multiple violations, any major violation or accidents, and lack of proper experience may not be eligible.

Any questions or problems with the form? Please contact Elizabeth Scott 800-396-6226 x102


Only Commonwealth Underwriters, Ltd. has binding authority. Coverage will not be bound until application has been received, reviewed, and accepted by Commonwealth Underwriters, Ltd.


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Last modified 2007-12-05