Capital Partners Insurance Agency, Inc
Call Us Toll Free
(800) 889-7162
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Applications
General Liability
Commercial property
Contractor General Liability
Contractor Workers Compensation
General Workers Compensation Insurance
Commercial Auto/Local Insurance
Commercial Long Haul Trucking Insurance
Contact
Call Us Toll Free
(800) 889-7162
Home
About Us
Products
Aircraft Insurance
Auto insurance
Boat Insurance
Commercial Building Insurance
Commercial Lines Insurance
Commercial Property Insurance
Condominium Insurance
Contractors Insurance
Earthquake Insurance
General Liability Insurance
Home Insurance
Importers and Manufacturers Insurance
Medical Malpractice Insurance
Mobile Home Insurance
Motorcycle Insurance
Professional Liability Insurance
Retailers and Wholesalers Insurance
Sexual Harassment Liability Insurance
Trucking or Commercial Auto Insurance
Workers’ Compensation Insurance
Applications
General Liability
Commercial property
Contractor General Liability
Contractor Workers Compensation
General Workers Compensation Insurance
Commercial Auto/Local Insurance
Commercial Long Haul Trucking Insurance
Contact
Commercial Long Haul Trucking Insurance
Commercial Truck Questionnaire:
Company Name:
Name
First Name
Last Name
DOT #
Phone Number
-
Area Code
Phone Number
How many years have you been in business?
New Venture:
YES
NO
Describe business
How many SQ Ft is the office space you occupy?
ANNUAL REVENUES:
$120,000 (1 year gross income)
Full Time Employees
Part Time Employees
Have you ever filed for Bankruptcy?
YES
NO
Which states do you operate?
CA NV AZ TX NY NJ
Do you haul for hire?
YES
NO
Do you operate over a regular route?
YES
NO
Are you a common carrier?
YES
NO
Are you a contract hauler?
YES
NO
List all types of cargo hauled:
Do you haul any hazardous or extra hazardous substances or materials as defined by EPA?
YES
NO
Do you haul your own cargo exclusively?
YES
NO
Do you pull double trailers?
YES
NO
Do you pull triple trailers?
YES
NO
Do you rent or lease your vehicles to others?
YES
NO
Do you hire any vehicles?
YES
NO
What is the basis for driver(s) pay?
Hourly
Trip
Mileage
Other
Submit
Should be Empty:
