Truck Insurance Quotes - Charles String Insurance

Did anyone refer you to us?

This quote is for:*

Have you had any claims in the last 3 years?*

Yes

No

Total Number of Claims?*

Business Name*

DBA Name

DOT Number

EIN / Tax ID

Don't include the dash! Format: 123456789

Date you applied for authority

Insurance Renewal Date*

Business Owner's Name*

We only list one business owner on applications. If there are multiple owners, enter the one that is most involved in daily operations of the business (hopefully this is the one with the best credit score too, just FYI). Credit history is one of the biggest factors in calculating your insurance costs.

First Last

Business Owner's Date of Birth*

Business Owner's SSN

Recommended for most accurate quote with new ventures.

Phone*

Please make sure you can answer this number if we need to call you. ***If you decide to change your number, make sure you let us know so we can update your account.

Email*

If you change your email address or add another address later, please let us know so we can communicate with you.

Business Owner's Home Address*

This should match the address on the Owner's Driver's License.

Street Address Address Line 2 City State ZIP Code

Is your Business Address the same as the Business Owner's Home Address?

Yes

No

Business Address*

Street Address Address Line 2 City State ZIP Code

Is your Mailing Address the same as the Business Owner's Home Address?

Yes

No

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Add any trucks and trailers you own or lease here

This section is not for rental trucks. If you plan on purchasing or leasing a truck, enter as much information about the truck as possible.

Trucks and Trailers

Year	Make	Model	VIN	Stated Value	Radius of Operation	Actions

There are no Trucks.

Is the Business Owner a Driver?*

Yes

No

Business Owner is:*

Married

Single

Driver's License Number*

License State*

Does the Business Owner have a CDL?*

Yes

No

What year was the CDL issued?*

Has the business owner completed an Accident Prevention Course in the past 3 years?*

Yes

No

Date you completed the course?*

Add additional drivers here:

Name	Date of Birth	License State	License Number	Actions

There are no Drivers.

Discounts

Do you currently have personal auto insurance?*

This is a HUGE discount so do not skip this if you have personal auto insurance!!!

Yes

No

We will need a copy of your current insurance ID card or Declarations Page, would you like to upload that now?*

You can do this later. We just need it prior to binding your policy.

Yes

No

Upload current Insurance ID card or Declarations Page or COI*

Max. file size: 10 MB.

Do you have any other insurance policies for the business?*

General Liability

Business Owner's Policy

None

What year did you incorporate your business?

ELD Provider*

If you haven't chosen an ELD provider yet, I highly recommend KeepTruckin / Motive. This discount will not apply unless you already have a truck and the device is active in it. You can still get the discount after the policy is bound, we just need to wait until you get it activated and then submit for it. If you are not sure, you should DEFINITELY get an ELD, this discount will more than pay for the ELD service and save you money on your insurance. Unless you select "N/A" you consent to providing your ELD data to the insurance company. Drive smart, save money.

Loss Runs / Claim Report

Please upload any loss run reports you have.

Drop files here or

Max. file size: 10 MB.

Through our agency and our partner agency, we can help you with insurance in every state.

Budget Vehicle Info: Year: 2016 Make: International Model: 268 VIN: 3ALACWFD4JDJL5407 Value: $75000 Additional Insured / Loss Payee: Avis Budget GRP INC P.O. Box 690360 Tulsa, OK 74169

Penske Rental Vehicle Info: Year: 2018 Make: International Model: MV607 VIN: 1HTMMMML6JH057052 Value: $120000 Additional Insured / Loss Payee: Penske Truck Leasing Co, LP Route 10 Green Hills P.O. Box 563 Reading, PA 19603

Enterprise Vehicle Info: Year: 2018 Make: International Model: MV607 VIN: 1HTMMMML6JH057052 Value: $90000 Additional Insured: Enterprise Leasing Company Southeast, LLC 8335 IBM Dr STE 100 Charlotte, NC 28262

Every time you get a new rental truck, you must email your agent the VIN so that it can be updated on the policy.

Add any trucks and trailers you own or lease here

Discounts

Coverages

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