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Rick Powell Insurance Agency - CA Commercial Auto Insurance

COMMERCIAL AUTO INSURANCE QUOTE


Rick Powell Insurance Agency LLC offers competitive quotes with exceptional carriers for your California Commercial Automobile Insurance. We would like to provide you with a free, no-obligation Commercial Automobile insurance quote. Please provide as much information as possible for the most accurate quote. This information will be kept confidential and will be used for quote and/or policy purposes only.

Commercial Auto Basic Information

General Information
Name of Insured:
Address:
City: State:
Zip:
Business Phone:
Fax Number:
Email Address:
Garaging Address
(type "same" if same as above):
City: State:
Zip:


Coverage Information
Liability Amount (csl):
Uninsured Motorist - Bodily Injury (csl):
Uninsured Motorist - Property Damage: Yes No
Medical:
Hired Auto: Yes No
Non-Owned Auto: Yes No
Comprehensive Deductible: Yes No If "Yes",
Collision Deductible: Yes No If "Yes",


Vehicle Information
You can list up to 5 vehicles on this form... reuse this form multiple times for additional vehicles
AUTO
#1
Year
Make
Model
VIN #
Gross Vehicle Weight
Cost New
Radius
(in miles, one way)
Vehicle Use
lbs.
$
Please describe in detail what the vehicle is used for:
If commodity is hauled, please explain:


AUTO
#2
Year
Make
Model
VIN #
Gross Vehicle Weight
Cost New
Radius
(in miles, one way)
Vehicle Use
lbs.
$
Please describe in detail what the vehicle is used for:
If commodity is hauled, please explain:


AUTO
#3
Year
Make
Model
VIN #
Gross Vehicle Weight
Cost New
Radius
(in miles, one way)
Vehicle Use
lbs.
$
Please describe in detail what the vehicle is used for:
If commodity is hauled, please explain:


AUTO
#4
Year
Make
Model
VIN #
Gross Vehicle Weight
Cost New
Radius
(in miles, one way)
Vehicle Use
lbs.
$
Please describe in detail what the vehicle is used for:
If commodity is hauled, please explain:


AUTO
#5
Year
Make
Model
VIN #
Gross Vehicle Weight
Cost New
Radius
(in miles, one way)
Vehicle Use
lbs.
$
Please describe in detail what the vehicle is used for:
If commodity is hauled, please explain:


Loss Information
How many losses have there been in the last 3 years? (If any, please explain below)


Additional Comments
Please give any additional comments you feel appropriate for this quotation. If you have
additional information where there was not enough fields above, please enter them here.


Once you click on the "Submit Quote" button you will be automatically re-directed to our home page and one of our representatives will respond to your submission as soon as possible.

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