CIC - Commercial Insurance Center

Miles Radius

Current Value

Garaged Zip Code

Gross Weight

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Quick Quote

Full Name:
Telephone:
Email:
Type of Insurance:	Personal Business
Insurance Needed

Additional Comments:

Commercial Auto Quote

A commercial auto insurance policy serves as protection against liability for bodily injury and property damage relative to your ownership, maintenance, or use of vehicles involved in doing business.

Texas commercial auto insurance also includes attorney fees, court costs and payment to the injured person. Trucks, certain motorized equipment, buses, limousines, and many types of vehicles can all be afforded coverage, in addition to the standard car or delivery van.

Your Texas business may also need “non-owned and hired” auto liability
coverage for vehicles your employees use or that you rent or borrow.

Texas Business Information

Business Name:
Premises Address:
City:
State:
Zip Code:
Contact Name:
Phone:	.Cel.: .Fax:
Years in Business:
Email Address: (Required)
Federal Employer's ID #:
Description of Operations or SIC code:

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Vehicle Information:

Vehicle	Year	Make	Model	Vehicle Type
1
2
3

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Additional Vehicle Information:

Texas Commercial Auto Insurance Coverage Information:

Vehicle	Liability Combined Limits	Property Damage	Uninsured Combined Limits	Medical
1
2	SAME	SAME	SAME	SAME
3	SAME	SAME	SAME	SAME

Vehicle	Collision Deductible	Comprehensive Deductible
1
2
3

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Texas Driver Information:

Driver	Drivers Name	Date of Birth	Gender	Drivers License #
1
2
3

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Is each employee's driving record accident & violation free during the past 5 years?

Driver	If No, how many accidents?	How many violations?
1
2
3

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Was any employee's driver's license suspended during the past 5 years?

Driver
1
2
3

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Recent Insurance Information:

Current Insurance Company:
Expiration Date:	(mm/dd/yyyy)
Any losses past 3 years:
Description of losses, including amount paid on each accident:
Additional Information or Comments:

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Click on the "Submit Quote Information" button below to send
your Texas Commercial Auto Insurance quote request.**

“Information received from this Texas Business Liability Insurance quote request form sent to our company, will be for our use only and will not be sold, given to or distributed to any other parties.”