Veterans Business Insurance.com Commercial Vehicle Insurance Quote - Veterans Doing California Commercial Insurance with Veterans!

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E-Mail:
dave@Veterans
BusinessInsurance.com

Phone:
1-714-369-8384

Facsimile:
1-866-832-4186

Office Address:
9114 Adams Ave. Suite 144
Huntington Beach, CA 92646

Insurance
License #:
License # 0756665

10 Reasons Why You Should Use Adams Avenue Insurance Agency:
1. We offer a "TRIPLE Money Back Guarantee" to every customer!
2. The best coverage at the lowest price.
3. Instant phone quotes for most products.
4. Low down payments & easy monthly installments on most policies.
5. Internet quotes returned within 24 business hours.
6. We have carriers that will insure houses with prior claims and that are in brush areas.
7. Rates are shopped exclusively for you with 25+ auto and home insurance companies.
8. Huge discounts on ALL insurance products!
9. Our experience allows us to match you with the carrier that best meets your needs.
10. We have been saving our customers money on insurance since 1988.

On-Line Commercial Vehicle Quote Form One Simple Form - takes only 2-3 Minutes! YOUR PERSONAL DATA:
Your Name:
Business Name:
Street Address:
City:
State:
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):

Currently Insured? (If yes, list carrier, and # of years continuous. If no, type NONE)

Type of Business: (Please be specific, and tell how vehicles are used.)


DRIVER INFORMATION #1 (if more than two drivers, list in remarks)
Name:		Birthdate:
Sex:		# Years U.S. Auto License:
Number & Type of Accidents within last 3 years:		Number & Type of MINOR violations within last 3 years:
Number & Type of MAJOR violations within last 3 years:		Daily commute in ONE WAY miles:
Does Driver need an SR22 FILING?	Yes No	Comments or Remarks?

DRIVER INFORMATION #2 (if none, leave blank)
Name:		Birthdate:
Sex:		# Years U.S. Auto License:
Number & Type of Accidents within last 3 years:		Number & Type of MINOR violations within last 3 years:
Number & Type of MAJOR violations within last 3 years:		Daily commute in ONE WAY miles:
Does Driver need an SR22 FILING?	Yes No	Comments or Remarks?

COMMERCIAL VEHICLE #1: If more than 2 vehicles, list in remarks or call us at: 1-714-369-8384
Year of vehicle:		Make & Model:
Type (truck, tow-truck, bobtail, etc.):		Length in Feet:
Gross Vehicle Weight:		Cost New: $
Radius of operation:		Value $:
List Special Equipment & Values (i.e., rack, tool box, etc.)
VEHICLE ID# (highly suggested for accurate rating)
VEHICLE #1 COVERAGES:
Limits of Liability:	$500,000 CSL $750,000 CSL $1 Million CSL

Comprehensive & Collision:	NO Coverage $250 Deductible $500 Deductible $1000 Deductible

Do you want Medical Coverage?	Yes No	Uninsured Motorists?	Yes No

COMMERCIAL VEHICLE #2:
Year of vehicle:		Make & Model:
Type (truck, tow-truck, bobtail, etc.):		Length in Feet:
Gross Vehicle Weight:		Cost New: $
Radius of operation:		Value $:
List Special Equipment & Values (i.e., rack, tool box, etc.)
VEHICLE ID# (highly suggested for accurate rating)
VEHICLE #2 COVERAGES:
Limits of Liability:	$500,000 CSL $750,000 CSL $1 Million CSL

Comprehensive & Collision:	NO Coverage $250 Deductible $500 Deductible $1000 Deductible

Do you want Medical Coverage?	Yes No	Uninsured Motorists?	Yes No


Send my quotation via:	E-Mail Fax Regular Mail Call Me by Phone

Thank you for filling out this form COMPLETELY!
We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

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Veterans Business Insurance.com
9114 Adams Ave., Suite 144
Huntington Beach, CA 92646
Phone: (714) 369-8384
Fax: (866) 832-4186
E-Mail us at:
dave@VeteransBusinessInsurance.com