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Policy Types
General Liability
Hired And Non-Owned Auto
Motor Truck Cargo
Occupational Accident
Primary Auto Liability
Physical Damage
Reefer
Trailer Interchange
Workers Compensation
Waste Haulers
Service Request
Complete Quote Form
Request a Quote
Menu
Home
Policy Types
General Liability
Hired And Non-Owned Auto
Motor Truck Cargo
Occupational Accident
Primary Auto Liability
Physical Damage
Reefer
Trailer Interchange
Workers Compensation
Waste Haulers
Service Request
Complete Quote Form
Request a Quote
Client Portal
Home
Policy Types
General Liability
Hired And Non-Owned Auto
Motor Truck Cargo
Occupational Accident
Primary Auto Liability
Physical Damage
Reefer
Trailer Interchange
Workers Compensation
Waste Haulers
Service Request
Complete Quote Form
Request a Quote
Menu
Home
Policy Types
General Liability
Hired And Non-Owned Auto
Motor Truck Cargo
Occupational Accident
Primary Auto Liability
Physical Damage
Reefer
Trailer Interchange
Workers Compensation
Waste Haulers
Service Request
Complete Quote Form
Request a Quote
Complete Trucking Insurance Quote Form
Our goal is to gather pertinent details necessary to provide you with
an accurate and personalized insurance quote.
Complete Quote Form - Hudson Trucking Insurance
"
*
" indicates required fields
Insured Information:
Business Name
*
MC / DOT #
*
EIN #:
Business Physical Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Is your mailing address the same as your business address?
Yes
No
Mailing Address (If different from physical address)
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Business Information:
Business Information
*
Business Start Date (MM/YYYY)
Entity Type
Filings Required?
Sole Proprietor
LLC
Inc./Corp
Other
No
Federal
State
Federal & State
Add
Remove
Does the Business have a DBA
*
Doing Business As
Yes
No
DBA Name:
Business Owner Driver Information:
Insurance companies required this information to provide a quote even if the owner is not a driver.
Business Owner Name
*
Cell
*
Email
*
Business Owner Driver Information
*
DOB (MM/DD/YYY)
License #
State
CDL EXP.
Trucking Industry Exp
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
No CDL
1
2
3
4
5
6
7
8
9
10+
No Exp
1
2
3
4
5
6
7
8
9
10+
Add
Remove
Is the owner a company driver?
*
Yes
No
Business Driver(s) Information:
Driver Information
*
First:*
Last:*
DOB MM/DD/YYYY:*
License #*
State*
CDL Exp:*
Date Hired (MM/YY)
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
1
2
3
4
5
6
7
8
9
10+
Add
Remove
Driver Related - Tickets or Accidents
*
Has ANY driver listed above had any violations or accidents within the last 3 years?
Yes
No
Please list the Driver name and briefly describe the ticket received or accident that occurred, for each driver involved.
TRUCK / TRAILER / EQUIPMENT INFORMATION:
Truck / Vehicle Information
*
Year
Make / Model
Type
Vehicle Value $
17 Digit VIN Number
Garaging Zip Code
Truck Tractor
Box Truck
Pickup Truck
Cargo Van
Delivery Van
Dump Truck
Auto Hauler
Gas Hauler
Flat Bed
Reefer Truck
Dry Van
Garbage Truck
Front Loader
Tow Truck
Car Carrier
Cement Mixer
Tank Truck
Other
Add
Remove
Is the vehicle garaging address the same as the business address?
Yes
No
Garaging address (If different from business address)
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Trailer / Scheduled Equipment Information
Year
Make
Model
Trailer Type
Trailer Value $
17 Digit VIN Number
Garaging Zip Code
Add
Remove
For Trailers, please specify if Dry Van, Reefer, Flat Bed, etc., in the type field
TRANSPORTATION OPERATIONS INFORMATION:
Business Operations Information:
*
Interstate or Intrastate
Travel Radius (Round Trip)
Average Load Weight?
Max Load Weight?
Interstate (more than 1)
Intrastate (one state)
100 miles
200 miles
300 miles
500 miles
Unlimited Miles
Add
Remove
Top 3 Commodities Hauled:
General Freight 1
General Freight 2
Consumer Goods
Building Supplies
Construction Mater.5
Paper Products
Amazon
Plastic Goods
Amazon
Other
Plastic Products
Canned Goods
Appliances
Office Equip
Amazon
Electrical Supplies
Stone Slabs
Plumbing Supplies
Other
Gravel & Rock
Sand
Asphalt
Cement
Other
Add
Remove
**Please select your top 3 Commodities Hauled from the drop downs
Commodities Hauled Continued:
F & B (Refrig)
Machinery Equip.
Waste & Recycling
Household (Mover)
Auto Hauler
Frozen(not Seafood)
Seafood(Fresh)
Seafood(Frozen)
Construction Equip
Machinery
Other
Residential
Construction
Electronics
Other
Yes
No
Yes
No
Add
Remove
Commodities Hauled
*
Yes
No
Did you select "OTHER" in any of the above "Top 3 Commodities Hauled?"
The underwriters will need a brief description of the "other" choices above. Please provide a brief description below.
INSURANCE COVERAGE INFORMATION:
PRIMARY INSURANCE COVERAGE REQUESTED:
*
Commercial Auto Liability*:
Auto Liability Ded.
Physical Damage
Motor Truck Cargo
Cargo Ded.
Trailer Interchange
$750K
$1 million
Other (see comments)
$1000
$2500
Yes
No
$100k
$150k
$200K
$250
None
Other (see comments)
$1000
$2500
$15K
$20K
$25K
$30
$40K
$50K
None
Add
Remove
Additional Insurance Coverage Requested:
Reefer
Workers Compensation
Hired / Non Owned Auto
Non Owned Trailer
50K
75K
100K
Other(see comments)
Yes
No
Yes
No
$15K
$20K
$25K
$30K
$40K
$50K
None
Add
Remove
Does your company require General Liability Insurance?
*
Yes
No
GENERAL LIABILITY INFORMATION*
*
Forecasted Revenue 12 months
Forecasted Payroll
Add
Remove
Additional Interests
Please provide information for a lien or additional named insured or make payable to:
Additional Interest
Last 4 of VIN #
Additional Interest Name
Street Address
City
State
Zip Code
Interest Type
Loss Payee
Additional Insured
Lien Holder
Leasing Agent
Other
Add
Remove
Interest Type: Loss Payee, Additional Insured, Lien Holder, Leasing Agent
Comments:
Upload a copy of the Driver’s licenses and current MVRs, and/or loss run information. (If available)
Drop files here or
Select files
Max. file size: 50 MB.
What Effective Date Would You Like for the Policy?:
*
MM slash DD slash YYYY
Consent
I agree to the Terms of Service.
The information you have provided is confidential and will be used by us to administer a response, document, or quote on your behalf. By submitting your data to us you agree to our storage and use of that data in this manner.
Email
This field is for validation purposes and should be left unchanged.