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Policy Review Request
Mobile Food Truck Quote
Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.
Type of mobile food vehicle?
Required
Truck
Trailer
Food Cart
Hold down the Ctrl Key to make multiple selections.
Garage location - Address
Required
Garage location - ZIP (5 digits)
Required
Garage location - State
Optional
Garage location - City
Required
New Venture?
Optional
Yes
No
Year Established
Required
Describe Prior Resturant Experience
Optional
Named Insured
Required
Doing Business As
Optional
First Name
Required
Last Name
Required
Phone
Required
ZIP / Postal Code
Required
E-Mail Address
Required
Mailing Address
Required
Mailing Address Zip
Required
Mailing Address State
Required
Mailing Address City
Required
Proposed Effective Date
Required
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Entity Type
Select type
Required
Corporation
SubChapter 'S' Corp
LLC
Partnership
Joint Venture
Individual
Operation Section
Type of Food Served
Required
What days of week will you operate
Required
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Hold down the Ctrl Key to make multiple selections.
What hours of day will you operate
Required
Normal (9AM - 11PM)
Late night (11PM - 9AM)
24 hours
Any policy or coverage declined, cancelled, or non-renewed in the past 3 years?
Required
Yes
No
Do you have a commissary?
Required
Yes
No
Name of Commissary
Optional
Address of commissary
Optional
Do you have employees?
Required
Yes
No
Number of employees:
Full Time
Optional
Part Time
Optional
Property
Business Personal Property
Optional
$5,000
$10,000
Estimated Annual Gross Receipts:
Required
Liability Endorsements Benefits Liability
Required
Blanket Additional Insureds
Blanket Waiver of Subrogation
Employee
Hold down the Ctrl Key to make multiple selections.
Auto Section
Hired and non owned autos?
Optional
Yes
No
Physical Damage
Comprehensive
Optional
Yes
No
Collision
Optional
Yes
No
Deductible for Comprehensive
Optional
1K
2k
3k
5k
Deductible for Collision
Optional
1k
2k
3k
5k
Would you like towing and Labor?
Optional
Yes
No
Do you order/check driving records prior to employment?
Optional
Yes
No
Driver Info (Minimum Age 21)
Name
Optional
Date of Birth
Optional
Drivers License#
Optional
State Licensed
Optional
Vehicle Questions
Is there automatic fire extinguishing system?
Optional
Yes
No
Number of fire extinguishers of type ABC
Optional
Number of fire extinguishers of type K
Optional
Vehicle Info
Vehicle ID Number
Optional
Year Established
Optional
Make
Optional
Model
Optional
Body Type
Optional
Length if Trailer
Optional
Radius
Optional
0-50 Miles
50-100 Miles
over 100 Miles
Owner Operated
Optional
Yes
No
Purchase Date
Optional
Purchase Price?
Optional
Customized Kitchen included in Purchase Price?
Optional
Yes
No
Anti lock braking system
Optional
2 Wheel
4 Wheel
None
Anti theft Devices
Optional
Basic Alarm-No Tracking
Lo-Jack
Tele Trac
other
Trailer Hitch Lock
Optional
Yes
No
Additional Interest?
Optional
Yes
No
Submission Validation
Required
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to
contact us
.
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