HOME | OUR COMPANY | CONTACT US
Daniels-Head Insurance

Business Auto Policy Cost Indication Form
Request an Estimate

Mailing Address Vehicle Garage Location
 

 

Please list all Vehicles Titled or Leased under the Business Name.
Include YEAR, MAKE, MODEL, VIN#, and Cost When New:
Description of how vehicles are used (including number of daily deliveries, if applicable):

Please list all Drivers to be covered under the Business Auto Policy.
Include DRIVERS FULL NAME, DATE OF BIRTH and DRIVERS LICENSE NUMBER:

Policy to be quoted with the following limits:
Liability Limit: $1,000,000 Combined Single Limit
Uninsured Motorist/Underinsured Motorist: $1,000,000 CSL
Hired & Non-owned Auto: $1,000,000 Combined Single Limit

HOME | PRIVACY POLICY | CONTACT US              All Rights Reserved Copyright © 2009 by Daniels-Head Insurance

Created and Maintained by WSI