Business Auto Insurance Quote — Business Insurance Brokers

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Effective Date

When do you need coverage to start?

Requested Effective Date * Current Policy Expiration (if switching) 🏢 Business InformationLegal name, DBA, EIN, and addresses Business Name (Corp, LLC, etc.) * DBA (if different) EIN # * Legal Entity Type * Select... Sole Proprietorship Partnership LLC S-Corporation C-Corporation Other Business Location Address Street Address * City * State * Select... WashingtonOregonIdaho NevadaArkansasSouth Dakota PennsylvaniaTexasIndiana Other ZIP Code * Mailing Address (if different) Mailing Street Address City State ZIP 👤 Owner InformationOwner details, license, and daily involvement Why we need this: Owner information is required for rating commercial auto policies. MVR (motor vehicle record) checks are standard for all listed drivers including the owner. Owner's Full Name * Owner's Date of Birth * Owner's Home Address * Owner's Social Security # * State & Driver's License # * Owner's Cell Phone * Owner's Email Address * Is Owner Involved in Daily Operation of the Business? *

Current Policy Expiration (if switching)

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Business Information

Legal name, DBA, EIN, and addresses

Business Name (Corp, LLC, etc.)

DBA (if different)

EIN #

Legal Entity Type

Business Location Address

Street Address

City

State

ZIP Code

Mailing Address (if different)

Mailing Street Address

City

State

ZIP

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Owner Information

Owner details, license, and daily involvement

Why we need this: Owner information is required for rating commercial auto policies. MVR (motor vehicle record) checks are standard for all listed drivers including the owner.

Owner's Full Name

Owner's Date of Birth

Owner's Home Address

Owner's Social Security #

State & Driver's License #

Owner's Cell Phone

Owner's Email Address

Is Owner Involved in Daily Operation of the Business?

Yes — full time Yes — part time No — passive owner

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Business Use & Operations

How, where, and what the vehicles are used for

Where Do You Drive From and To? * Average # of Job Sites / Trips / Deliveries / Errands Per Day * What Do You Haul? (tools, equipment, goods, passengers, etc.) Do You Have a DOT #? *

Average # of Job Sites / Trips / Deliveries / Errands Per Day

What Do You Haul? (tools, equipment, goods, passengers, etc.)

No Yes

No Yes Unknown 🚙 Vehicles Complete one entry per vehicle — add as many as needed Add Another Vehicle 🧑‍✈️ Additional Drivers (Optional) Add one entry per hired driver beyond the owner — if applicable If the owner is the only driver, you can skip this section. Add one entry for each employee or hired driver who operates a business vehicle. Add Driver 📎 Upload Documents (Optional) Attach current dec pages and/or loss runs to speed up quoting Why upload? Your current declarations page shows existing coverage limits and carrier. Loss runs show your claims history. Both help us return a more accurate, faster quote. Current Dec Page(s) 📄 Declarations Page PDF, JPG, PNG, or DOC — max 10 MB Loss Runs 📊 Loss Run Report 3–5 years preferred — PDF, XLS, or DOC Max 10 MB per file · You can also email documents directly to [email protected] Ready to Submit? A licensed commercial auto broker will review your submission and respond within one business day with coverage options tailored to your fleet. Loading... Submit Quote Request › ✓ Your business auto insurance quote request has been received. A broker will contact you within one business day. Thank you! Consent is not a condition of purchase. See our Privacy Policy. Jump to Submit // ── PROGRESS ────────────────────────────────────────────────────────────────── function updateProgress(){ const els=document.querySelectorAll('[name]:not(.hp)'); let total=0,filled=0; const seen=new Set(); els.forEach(el=>{ if(!el.name||el.type==='file') return; if(el.type==='radio'||el.type==='checkbox'){ if(seen.has(el.name)) return; seen.add(el.name); total++; if(document.querySelector(`[name="${el.name}"]:checked`)) filled++; } else { total++; if(el.value&&el.value.trim()) filled++; } }); const pct=total?Math.round((filled/total)*100):0; document.getElementById('progressFill').style.width=pct+'%'; document.getElementById('progressLabel').textContent=pct+'% complete'; } document.addEventListener('input',updateProgress); document.addEventListener('change',updateProgress); // ── TOGGLES ─────────────────────────────────────────────────────────────────── function toggleDOT(el){ document.getElementById('dot_num').style.display=el.value==='Yes'?'block':'none'; } // ── VEHICLE REPEATER ────────────────────────────────────────────────────────── let vCount=0; function addVehicle(){ vCount++; const n=vCount; const div=document.createElement('div'); div.className='repeater-card'; div.id='veh_'+n; div.innerHTML=` ${n} Vehicle ${n} ${n>1?`Remove`:''} Vehicle Details Year * Make * Model * Trim / Package VIN # * Current Mileage * Ownership & Use Name on Title * Who Drives This Vehicle? * Business, Personal, or Both? * Yes Unknown

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Vehicles

Complete one entry per vehicle — add as many as needed

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Additional Drivers (Optional)

Add one entry per hired driver beyond the owner — if applicable

If the owner is the only driver, you can skip this section. Add one entry for each employee or hired driver who operates a business vehicle.

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Upload Documents (Optional)

Attach current dec pages and/or loss runs to speed up quoting

Why upload? Your current declarations page shows existing coverage limits and carrier. Loss runs show your claims history. Both help us return a more accurate, faster quote.

Current Dec Page(s)

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Declarations Page

PDF, JPG, PNG, or DOC — max 10 MB

Loss Runs

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Loss Run Report

3–5 years preferred — PDF, XLS, or DOC

Max 10 MB per file · You can also email documents directly to CommercialInsuranceAgency@gmail.com