Auto-Commercial quote


To receive a prompt reply from FITS, please send your inquiry by providing the information below.

(*- required field)

Business Name*:

Applicant Name*:

Mailing Address*:

City*:

Zip*:

Location Address*:

City*:

Zip*:


Contact Information:

Email*:

Phone*:

Fax:


Business Information:

Type of Business*:


What is your line of work?*:


Federal ID/SSN*:

Years in Business*:

Do you have insurance?

Prior Carrier:

Total Premium:


Drivers:

Name
DL#/State
SS#
(xxx-xx-xxxx)
DOB
(xx/xx/xx)
Marital
Status
(M/S/D)
Sex
(M/F)
Date
Hired
(xx/xx)
Years
Exp.



Vehicle:

VIN#
Year
(xxxx)
Make
Model
Value
(xx,xxx)
Radius
Use
Comp/
Coll
 Deductible
Liability
Coverage
UI/UIM
Coverage
GVW



Do you need General Liability?

Do you need Worker's Compensation?

Do you need Commercial Property?

Do you need Equipment/Tool Coverage?