Truckers Quick Quote Request

Locally Owned & Operated by
Brown's Insurance Agency, Inc.
9168 Prince William Street
Manassas, VA 20110
Tel. 703-368-0333

Brown's Insurance Agency, Inc.
Truckers Quick Quote Request

You may expect a quote within the next two business days.

How did you hear about Brown's Insurance?

Name of Company:

E-MAIL Address:

What do you haul?
Dirt, sand and gravel
Other freight
If Other freight, please describe as completely as possible

Where are your vehicles garaged when not being driven?
(Please provide complete address including zip code.)

What is the average one way length of haul?
From (City) to (City).

Do you operate under a long term lease? Yes No
If "Yes," to whom? Please provide name, city, state, and for how long.

Do you trip lease? Yes No
If "Yes," what percentage of miles are under trip lease?

Do you want bob-tail coverage, or regular full time liability?
Bob-tail
Full time liability

Do you need a Virginia for hire Form E filing? Yes No
(If you are hauling for hire in Virginia, the answer is probably yes.)

Do you need ICC filings and filings for other states? Yes No
If "Yes," please list the states:

What limit of liability do you want?
$750,000
$1,000,000

Do you need cargo coverage? Yes No
If "Yes," how much?

Vehicle Information:

Vehicle number one:
Year Make
Model
Current Value
Gross Vehicle Weight
Average annual miles
Do you want comprehensive or specified perils coverage? Yes No
Do you want collision coverage? Yes No

Vehicle number two:
Year Make
Model
Current Value
Gross Vehicle Weight
Average annual miles
Do you want comprehensive or specified perils coverage? Yes No
Do you want collision coverage? Yes No

Vehicle number three:
Year Make
Model
Current Value
Gross Vehicle Weight
Average annual miles
Do you want comprehensive or specified perils coverage? Yes No
Do you want collision coverage? Yes No

Vehicle number four:
Year Make
Model
Current Value
Gross Vehicle Weight
Average annual miles
Do you want comprehensive or specified perils coverage? Yes No
Do you want collision coverage? Yes No

Vehicle number five:
Year Make
Model
Current Value
Gross Vehicle Weight
Average annual miles
Do you want comprehensive or specified perils coverage? Yes No
Do you want collision coverage? Yes No