Free Quote

Please provide the information requested on the Quote Sheet, then print it out and fax it to (850) 683-8118.
We will develop an individualized response based upon your request. You may send it in by mail, fax, or email. Please call (800) 761-5540, (850) 683-8008, or email sales@allflti.com if you have any questions.

Click here for Quote Sheet in Adobe Acrobat format. This is best used to print out the form, fill it out, and either mail or fax it in.

Attention:Linda Payne At: All Florida Truck Insurance, Inc., www.allflti.com

Date:
Insured Name:

Mailing Address:
City: ST: ZIP:

Garage Address:
City: ST: ZIP:

Phone: County:

Radius One Way: Fax:
States Majority Travelled:
Cell:
SS# and Fed ID#
Major Cities Travelled In:
Major Cities Less Than 12 Times Per Year:
*Contract/Common* MC#
Is Business In City Limits?
Commodities Hauled:

Percentage By Miles: 0-200 % 201-500 % 501-750 % Over 750 %

Description of operations:
Hauls for:
Exclusive? Yes No
Previous Carrier:
Losses:
Expiring Premium: Target Premium:
Renewal Date:
Losses:

Vehicles	VIN Number	Phys Dam Value	Deductible
1)
2)
3)

Drivers	Age (DOB)	License	M/S	Exp
1)
2)
3)

Please quote the limits below:
Liability CSL BI/PD
UM PIP Cargo
Limit Reefer: Yes No Reefer Deductible:

Commodities	Percentages	Average Value	Maximum Value
1)		$	$
2)		$	$
3)		$	$

Physical Damage: Yes No per values stated above.

Losses:
Remarks:

All Florida Truck Insurance Inc., www.allflti.com, Fax: (850) 683-8118

Linda G. Payne, Linda@allflti.com P.O. Box 189, 105 Navajo Trace, Crestview, Fl 32536