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Equipment Floater/Inland Marine Quote


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Personal Information
First Name
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Last Name
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Company Name (include entity type)
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FEIN
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Type of Business
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Years in Business
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Mailing Address
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City
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State
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ZIP / Postal Code
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Phone Number
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E-Mail Address
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Scheduled Equipment
Identify all Scheduled Equipment (include equipment make/model and coverage limit)
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Is any equipment leased or rented?
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If yes, what limit?
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Annual Rental Expenditures
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Is any equipment rented to others?
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Loss Payee
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Submission Validation
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Important Notice
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