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Intermodal Trucking Companies looking for an expert with the UIIA Intermodal Association.



Whether it be Trailer interchange, Primary Liability, or Cargo, we
haveagents available to take your call.


Ocean Marine

We offer a wide arrangement of Freight Broker and Freight Forwarder

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Get A Truck Insurance Quote


*

*Required

*Date:

*Name:
*Address:
*City:
*State: *Zip:
*Phone#:
Fax #:
*E-mail:

Coverages
*Auto Liability (Please select one)

Motor Truck Cargo

$Coverage Limit
$Deductible
(Normal shipper requirements are $100,000)

Additional Coverages

Non-Truck Liability(Bobtail)
*For owner-operators only

Truck Physical Damage(Damage to your vehicle)

Equipment
* For types, use...TT=Tractor, ST=Straight Truck, TR=Trailer, PASS=Passenger/Bus
*Year *Make *Type Full Serial-VIN (optional) Value *Radius of Operation
1)
2)
3)
4)
5)

Operations

ICC Docket Number:   Years In Business:

For Hire:       Filings Needed:

*Commodities Hauled (by % of time): (If "General Freight", please be as specific as possible.)


Reefer Breakdown Coverage?:   (Standard Reefer Break-Down Deductible $2,500)

*Major Cities traveled to: (Please provide 3)



If in KY, is truck garaged in city limits?


If permanently leased:
Name of Lease Company:
Address:
Phone #: Fax #:

Drivers

Please note: Qualified drivers must have at least 2 years CDL A OTR experience.

*Driver Name 1) 2)
Date of Birth 1) 2)
Drivers Lic # /State Issued 1) 2)
Soc. Security # 1) (Optional) 2) (Optional)
Yrs Experience 1) 2)
Tickets/Accident 1) (Last 3 yrs) 2) (Last 3 yrs)
Covered by W/C 1) 2)

*Driver Name 3) 4)
Date of Birth 3) 4)
Drivers Lic # /State Issued 3) 4)
Soc. Security # 3) (Optional) 4) (Optional)
Yrs Experience 3) 4)
Tickets/Accident 3) (Last 3 yrs) 4) (Last 3 yrs)
Covered by W/C 3) 4)

*Driver Name 5)
Date of Birth 5)
Drivers Lic # /State Issued 5)
Soc. Security # 5) (Optional)
Yrs Experience 5)
Tickets/Accident 5) (Last 3 yrs)
Covered by W/C 5)

           Thank you for your time in submitting this insurance quote form.

          A representative from our agency will contact you as soon as possible.