Business Insurance Quotes Online

Add / Delete / Replace Additional Interest

 

Change Mailing Address

Used to update or correct the current Mailing Address - spelling, incorrect street number, P.O. Box, Zip Code, etc.

 

Add / Delete / Replace Workers' Comp Classification/Location

 

Add / Delete / Replace Property Location

Used when the physical location of an office has changed or the purchasing of new office space has occurred.

 

Change Name of Insured

 

Add / Replace / Delete Vehicle

Type in your phone number, click on "Call Me" and be connected instantly

Online Live Chat

Add Vehicle

Insured Name*		Policy Number*
Effective Date of Change*
Contact Email*		Contact Phone*
New Vehicle Information
Year (YYYY)		Make	choose one AC Bristol Acura Alfa Romeo American Motors Aston Martin Audi Austin Austin-Healy Avanti BMW Bentley Borgward Buick Cadillac Capri Checker Chevrolet Chrysler Citroen Colt Crosley DAF DKW Daimler Datsun DeSoto Dodge Eagle Ferrari Fiat Ford Frazer GMC Hillman Honda Hudson Hyundai Imperial Infiniti Isuzu Italia Jaguar Jeep Lancia Land Rover Lexus Lincoln Lotus MG Maserati Mazda Mercedes-Benz Mercury Merkur Mitsubishi Moretti Morgan Morris Moskvitch NSU Prinz Nash Nash-Healey Nash-Metropolitan Nissan Oldsmobile Opel Packard Panel Deliveries Pantera Peugeot Pick-up Plymouth Pontiac Porsche Rambler Renault Riley Rolls Royce Saab Sedan Simca Singer Sterling Studebaker Subaru Sunbeam Suzuki TVR Taunus Toyota Triumph Vauxhall Vespa Volkswagen Volvo Willys Yugo Other
		Model
Vehicle Identification Number (VIN)
Garaging City		Garaging State
Garaging Zip Code		Registration State
Registered Owner		Legal Entity	choose one Corporation Individual Other
Trucks
Special Industry Class (SIC)
choose one Carriers Engd in Privt Carriage & Transp Goods Contr Electr,Plumb,Masonry,Plastering & Other Repair/Service Contract Carriers (Not Chemical or Iron & Steel Haulers) Contract Carriers Hauling Chemicals Contract Carriers Hauling Iron & Steel Contractors All Other Contractors Bldg-Private Dwellings Contractors Building-Commercial Contractors Excavating Contractors Street&Road Dump&Transit Mix Trks&Trlrs AllOther Dump&Transit Mix Trks&Trlrs Mining Dump&Transit Mix Trks&Trlrs Qryng Dump&Transit Mix Trks&Trlrs Sand&Gravel-not quarrying Dump&Transit Mix Trucks&Trls Excvtg Exmpt Carriers Hauling Livestck Exmpt Carriers-Not Livestck Haulers Farmers All Other Farmers Indiv Owned or Family Corp.(Not Livestck Hauling). Farmers Livestock Hauling Food Delivery All Other Food Delivery Canneries&Pkg Plants Food Delivery Fish & Seafood Food Delivery Frozen Food Food Delivery Fruit & Vegetable Food Delivery Meat or Poultry Not Otherwise Specfd Loggin&Lumberng Not Otherwise Specified All Other Specd Delivery Mall&Parcel Post Specd Delivery Mgzn/Newspaper Specialized Delivery All Other Specialized Delivery Armored Cars Specialized Delivery Film Delivery Trucker All Other Trucker Common Carriers Trucker Tow Trucks For-Hire Waste Disp Blg Wrckng Operators Waste Disposal All Other Waste Disposal Auto Dismantlers Waste Disposal Garbage Waste Disposal Junk Dealers
Radius		GVW
USE	choose one Commercial Service Retail
Private Passenger Type (PPT)
Licenesed less than 5 years:		Yes  No
	Operator⁄Owner:	choose one No Operator Not Owner or Principal Owner or Principal
Physical Damage
Does this vehicle have Physical Damage coverage? Yes  No
Cost New		Stated Amount *
Deductible
Comprehensive Deductible		choose one Acutal Cash Value $50 $100 $250 $1,000 $2,000 $3,000 Other
If deductible is OTHER, please indicate amount
Collission Deductible		choose one Acutal Cash Value $50 $100 $250 $1,000 $2,000 $3,000 Other
If deductible is OTHER, please indicate amount
Please explain all additional coverages in Comments and Special Instructions
Lienholder Information
If financed or leased, complete the following: Lender's/Lessor's Name
		Loan Number
	Mailing Address
Additional Drivers
First Name		Middle Initial
Last Name		Date of Birth (mm/dd/yyyy)
Driver License Number
		State
Please enter any more Additional Drivers in Comments and Special Instructions

 

Replace Vehicle

Insured Name*		Policy Number*
Effective Date of Change*
Contact Email*		Contact Phone*
Old Vehicle
Vehicle VIN		Vehicle Make
Vehicle Model		Vehicle Year (YYYY)
New Vehicle
Vehicle VIN		Vehicle Make
Vehicle Model		Vehicle Year (YYYY)
If condition of the new Vehicle is "USED" please enter current odometer showing:
Describe all existing damages to the vehicle:

 

Delete Vehicle

Insured Name*
Policy Number*
Effective Date of Change*
Contact Email*
Contact Phone*
Vehicle to be deleted
Vehicle VIN
Vehicle Make
Vehicle Model
Vehicle Year (YYYY)

Add Property Location

Insured Name*
Policy Number*
Effective Date of the Change*
Does this change apply to Mailing Address?*	Yes  No
Contact Email*
Contact Phone*
New Location
Street Address
City
State	Zip Code*
Description of Business operations at new location:
Building Limit
Business Personal Property Limit
Personal Property of Other Limit
Do you want to include General Liability	Yes  No
Construction Type	choose one Fire Resistive Frame Joisted Massonry Massonry Non-Combustible Massonry Non-Combustible with wind-resistive roof Non-Combustible Veneer
Year Built
Area Occupied
Sprinklers	Annual Sales/Receipts/Payroll:
Location of Additional Interest
Type of Interest	choose one Additional Insured, Lessor Contract of Sale Lender’s Loss Payable Loss Payee Mortgagee
Name Additional Interest
Street Address*
City*
State*
Zip Code*
Comments and Special Instructions

Replace Property Location

Insured Name*
Policy Number*
Effective Date of the Change*
Does this change apply to Mailing Address?*	Yes  No
Contact Email*
Contact Phone*
New Location
Street Address*
City*
State*
Zip Code*
Description of Business operations at new location:
Building Limit
Business Personal Property Limit
Personal Property of Other Limit
Do you want to include General Liability*	Yes  No
Construction Type*	choose one Fire Resistive Frame Joisted Massonry Massonry Non-Combustible Massonry Non-Combustible with wind-resistive roof Non-Combustible Veneer
Year Built*
Area Occupied*
Sprinklers	Annual Sales/Receipts/Payroll:
Location of Additional Interest
Type of Interest	choose one Additional Insured, Lessor Contract of Sale Lender’s Loss Payable Loss Payee Mortgagee
Name Additional Interest
Street Address*
City*
State*	Zip Code*
Replaced Location
Street Address*
City*
State*	Zip Code*
Comments and Special Instructions

Delete Property Location

Insured Name*
Policy Number*
Effective Date of the Change*
Does this change apply to Mailing Address?*	Yes  No
Contact Email*
Contact Phone*
Location to be deleted
Street Address*
City*
State*	Zip Code*
Comments and Special Instructions

Add Workers' Compensation Classification / Location

Insured Name*
Policy Number*
Effective Date of the Change*
Is a new location being added?*	Yes  No
Contact Email*
Contact Phone*
Location Address
Number of Employees being added
Street Address*
City*
State*	Zip Code*
1. Employees' Duties or class codes if known
	Annual Payroll
2. Employees' Duties or class codes if known
	Annual Payroll
3. Employees' Duties or class codes if known
	Annual Payroll
Comments and Special Instructions

 

Replace Workers' Compensation Classification / Location

Insured Name*
Policy Number*
Effective Date of the Change*
Is a new location being added?*	Yes  No
Contact Email*
Contact Phone*
Location Address
Number of Employees being replaced
Street Address*
City*
State*	Zip Code*
1. Old Description of Employees Duties or class codes if known
	Annual Payroll
New Description of Employees Duties or class codes if known
	Annual Payroll
2. Old Description of Employees Duties or class codes if known
	Annual Payroll
New Description of Employees Duties or class codes if known
	Annual Payroll
3. Old Description of Employees Duties or class codes if known
	Annual Payroll
New Description of Employees Duties or class codes if known
	Annual Payroll
Comments and Special Instructions

Delete Workers' Compensation Classification / Location

Insured Name*		Policy Number*
Effective Date of the Change*
Contact Email*		Contact Phone*
Location Address
Street Address*		City*
State*		Zip Code*
Please select the Option you wish to perform, delete entire state, delete a location or delete a classification code
delete	Select Delete Classification Code Delete Location Delete Entire State
delete	Select Delete Classification Code Delete Location Delete Entire State
delete	Select Delete Classification Code Delete Location Delete Entire State
Comments and Special Instructions

 

 

Add Additional Interest

Insured Name*
Policy Number*
Effective Date of the Change*
Contact Email*
Contact Phone*
New Additional Interest
Name*
Street Address*
City*
State*	Zip Code*
Please describe how the above interest applies (landlord, vendor, owner, etc)
Comments and Special Instructions
Please provide any specific wording requested for the certificate

 

Replace Additional Interest

Insured Name*
Policy Number*
Effective Date of the Change*
Contact Email*
Contact Phone*
New Additional Interest
Type of Interest	choose one Additional Insured/Lessor Contract of Sale Lenders Loss Payable Loss Payee Mortgagee
Name*
Street Address*
City*
State*	Zip Code*
Please describe how the above interest applies
Replaced Additional Interest
Type of Interest	choose one Additional Insured/Lessor Contract of Sale Lenders Loss Payable Loss Payee Mortgagee
Name*
Street Address*
City*
State*	Zip Code*
Comments and Special Instructions
Please provide any specific wording requested for the certificate

 

Delete Additional Interest

Insured Name*
Policy Number*
Effective Date of the Change*
Contact Email*
Contact Phone*
Delete Additional Interest
Type of Interest	choose one Additional Insured/Lessor Contract of Sale Lenders Loss Payable Loss Payee Mortgagee
Name*
Street Address*
City*
State*	Zip Code*
Comments and Special Instructions

 

Change of Mailing Address

Insured Name*
Policy Number*
Effective Date of the Change*
Contact Email*
Contact Phone*
Old Address
Street Address*
City*
State*	Zip Code*
New Address
Street Address*
City*
State*	Zip Code*
Phone	Fax
Comments and Special Instructions

 

Change of Name of Insured

Effective Date of the Change*
Policy Number*
Old Name of Insured
Old Name of Insured*
Old Legal Entity*	choose one Assoc Condo Owner Corp Individual Joint Venture Municipality Non Profit Partnership Other
New Name of Insured
New Name of Insured*
New Legal Entity*	choose one Assoc Condo Owner Corp Individual Joint Venture Municipality Non Profit Partnership Other
Reason for Change
Please explain the reason for this change and identify any changes in ownership.*