The Baxter Agency
Your one stop shop for trucking insurance!
NEED A QUOTE?
"Are you seeing your rates increase, even though your loss ratio has been profitable?"
We Can Bind Coverage Immediately
for All Truck Insurance Services.
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or
Call 1-800-873-8494
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Request for Certificate
of Insurance
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Change of Address
form
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MVR form
Business / Commercial Quote Form
First & Last Name:
Business Name:
Street Address:
City, State & Zip:
E-Mail Address:
Telephone:
Fax:
Current Insurance Information
Insurance Company Name:
Any Losses in last 3 yrs?:
Premium Amount:
Policy Exp. Date:
Describe the Type of Coverage
you Currently have:
About Your Business
# of Full-time
# of Part-time
Yrs. in Business
# of Locations:
Yr. building built
Sprinklered?
Annual Gross Sales
Square Footage?
Yes
No
Building Type:
Masonry
Framed
Type of Business:
Please select
Wholesaler
Retailer
Manufacturer
Contractor
Apartment
Service
Owned Autos:
Est. payroll / mo.:
Please describe your business here:
