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Current Quote Status
Started:
02/20/2017
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Rachel Patterson, CIC If at any time you need assistance please contact Rachel Patterson, CIC at 800-342-5572 or rachel@jsausa.com
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2017 CE Dates and Cities Available

Homeowners Program Start Quote
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Trucker GL Quote

Important Information! This is a stand alone Trucker GL quoter designed much like our Artisan Program. If you have a risk that needs more than just the Trucker class, please click here for the Artisan Program.

Applicant Information
Applicant Name:
Select a State:

Agency Information
Agent Name:
Note: This is the name of the agent requesting the quote, NOT the agency name.
Agency Name:
Agency Phone:  -  - 
Agency Fax:  -  - 

Quote Information
Choose a Limit:
Does the applicant haul for UIIA?  
 
Number of additional insureds needed
without a waiver of subrogation:
(Do not include UIIA additional insureds.)
Number of additional insureds needed
with a waiver of subrogation:
(Do not include UIIA additional insureds.)

Cost Information
Gross Receipts: $
Total Payroll:
Must include owner(s)
Select a state above for the minimum payroll info.
$

Loss Information
Number of losses within the last 3 years:
If number of losses is greater than zero, please specify the total amount of loss: $

Underwriting Questions
Desired effective date?
What is the desired effective date?
Does the applicant haul any fuel, oil, gasoline, chemicals, or hazardous waste?  
 
Does the applicant carry Auto Liability limits less than the selected General Liability limits?  
 
Does the applicant perform any repossession work?  
 
Is the applicant a household goods mover?  
 

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This program is only available to properly licensed retail insurance offices
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