FL Commercial Auto Insurance Quote

We offer affordable Florida business auto insurance quotes to businesses in
the following south Florida counties and cities: Miami-Dade County,
Broward County, Palm Beach County, Coral Gables, Kendall, Richmond
Heights, Pinecrest, Howard, Coral Way Village, Westchester, Westwood
Lakes, Brownsville, Sweetwater, Key Biscayne, North Bay Village, Miami
Beach, Miami Springs, Virginia Gardens, Hialeah, El Portal, Miami Shores,
Indian Creek, Surfside, Bal Harbour, North Miami, Biscayne Park,
Pinewood Park, Opa Locka, Bunche Park, Hialeah Gardens, Palm Springs
North, Carol City, Miami, Norland, Ojus, Miami Lakes, Biscayne Gardens,
Hallandale, Sunny Isles Beach, Golden Beach, Aventura, Uleta, Miramar,
Pembroke Pines, North Miami Beach, Hallandale Beach, Ives Estates,
Pembroke Park, Hollywood, Dania Beach, Cooper City, Davie, Weston,
Plantation, Playland Isles, Melrose Park, Lauderhill, Sunrise, Tamarac, Fort
Lauderdale, Wilton Manors, Oakland Park, Lauderdale Lakes, Sea Ranch
Lakes, Pompano Beach, Margate, Coral Springs, North Lauderdale,
Lighthouse Point, Hillsboro Beach, Coconut Creek, Deerfield Beach, Boca
Raton, The Hamptons, Highland Beach, Boca West, Delray Beach, Boca
Pointe, Boynton Beach, Lantana, Rainbow Lakes, Atlantis, Lake Worth,
South Palm Beach, Palm Springs, Greenacres, Wellington, Haverhill, Palm
Beach, Golden Lakes, Riviera Beach, Glen Ridge, West Palm Beach, Lake
Park, Royal Palm Beach, Jupiter, Juno Beach, North Palm Beach,
Loxahatchee, Belle Glade, Palm Beach Shores, South Miami, Cutler Ridge,
Princeton, Perrine, Naranja, Homestead, Florida City, and Leisure City, FL

Information received from this south Florida commercial auto insurance quote form sent to
Insurance Benefit Agency will be for our use only and will not be sold, given to or distributed to any
other parties. A quote will be based on the Florida commercial auto insurance information provided
and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to
meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as issued.
By submitting this request you acknowledge that this is neither an offer to insure nor a
guarantee of insurance. Completion of this form does not entitle your business to a Florida
commercial auto insurance. We are licensed in Florida only and will not provide commercial auto
insurance quotes for other states.

Business Name:
Premises Address:
City: Florida       Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required)

Radius of Operations:

Description of Operations or SIC code:

Florida Commercial Vehicle Information
Vehicle     Year           Make                Model                 Body Type           Cost Value
     1
     2
     3
     4
     5

What type of anti-lock brake system is each vehicle equipped with?
Vehicle
     1
     2
     3
     4
     5

                      Liability                    Uninsured                                             Collision         Comprehensive
Vehicle    Limits(x $1,000)      Motorist(x $1,000)       Medical              Deductible           Deductible
     1
     2
     3
     4
     5

                                  Drivers                          Date of                                              Drivers
Driver                       Name                               Birth                  Gender                 License #
     1
     2
     3
     4
     5

Is each employee's driving record accident & violation free during the past 5 years?
Driver
     1       If No, how many accidents?    How many violations?
     2       If No, how many accidents?    How many violations?
     3       If No, how many accidents?    How many violations?
     4       If No, how many accidents?    How many violations?
     5       If No, how many accidents?    How many violations?

Other Insurance Company Used Within Past 3 Years:
Policy #:
Losses past 3 years:
Description of losses or loss runs:

Current Yearly Insurance Premium: $

Additional Information or Comments

Click on the "Submit Quote Information" button below to send
your Florida commercial auto insurance quote request.