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 *

Last Name *

Company Name (include entity type) *

FEIN *

Type of Business *

Years in Business *

Mailing Address *

City *

State *

ZIP / Postal Code *

Phone Number *

E-Mail Address *

Scheduled Equipment

Identify all Scheduled Equipment (include equipment make/model and coverage limit) *

Is any equipment leased or rented? *

If yes, what limit?

Annual Rental Expenditures

Is any equipment rented to others? *

Loss Payee

Submission Validation

Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.

Insurance Websites Designed and Hosted by Insurance Website Builder

14285 Midway Road, Suite 100, Addison, TX 75001
Phone: 214-301-3333 | info@brookstone-group.com