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Midwest Insurance Center Logo
  • Business

    Business Insurance

    We provide small businesses with a variety of different coverage & policy options that fit their needs.
    View All
    Need a policy recommendation?
    Answer 3 questionsAnswer 3 questions
    Builders Risk
    Business Interruption
    Business Owners Policy
    Cargo
    Commercial Auto
    Commercial Trucking
    Cyber Liability
    Directors & Officers
    Employment Practices Liability
    Equipment Breakdown
    Equipment Floater / Inland Marine
    General Liability
    Liquor Liability
    Products Liability
    Professional Liability E&O
    Property
    Umbrella
    Workers Compensation
    • General Liability
    • Workers Comp
    • Commercial Auto
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    • Professional Liability
    • Business Owners Policy (BOP)
    • Commercial Package
    • EPLI Insurance
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    • Commercial Umbrella
    • Inland Marine
    • Liquor Liability
    • Product Liability
    • Disability Insurance
    • Errors and Omissions
    • Business Interruption Insurance
    • Builders Risk
    • Mechanical Breakdown
    • Cargo
    • Bonds
  • Personal

    Personal Insurance

    We offer insurance for individuals and families, including customized coverage, to fit your lifestyle.
    View All
    Auto + Home
    Boat
    Classic & Exotic Cars
    Condo
    Course of Construction
    Earthquake
    Equine
    Flood
    High Net Worth
    Jewelry
    Landlords
    Life
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    Powersports
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    Midwest Insurance Center

    944 U.S. Hwy 30
    Schererville, Indiana 46375
    Phone: 219-864-3333
    Fax: 219-864-9393
    Email: info@midwestic.com

    M-F 8:30am – 5pm CST

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Trucking Insurance Quote

Trucking Insurance QuoteTimothy Dekker2024-06-12T16:41:37-04:00

"*" indicates required fields

1Basic Info
2Contact(s)
3Trucks & Trailers
4Drivers
5Commodities
6Additional Insureds
7Wrapping Up

Basic Information

Is your business currently insured?*
Current policy expiration date*
Is this a New Venture or was there a Lapse in Coverage?*
Desired Coverages*
(Select all that apply)
MM slash DD slash YYYY
Do you have a DOT#?*
Do you have an MC#?*
Do you have a Tax ID Number?*
How is the business structured?*
Has the business either Currently or Previously operated under a DBA?
Business Mailing Address*
Business Garaging Address
Are all vehicles garaged at the same location?*

Primary Contact

Name*
Date of Birth*
Can we text you?*
Please visit our Privacy Policy regarding Texting/SMS communication.
Designated Financial Responsibility for Company?*
What is your Role?*
  • Owner / Operator - Both a Manager and included on the policy as a Driver.
  • Manager - Strictly a manager, is NOT a Driver on the policy.
  • Other - Anyone besides the Owner / Management that has been authorized to contact us on their behalf, particularly to make modifications to their Policy / Coverages.
Is there a Secondary business contact?*

Secondary Contact

Secondary Contact: Name*
Secondary Contact: Date of Birth*
Secondary Contact: What is your Role?*
  • Owner / Operator - Both a Manager and included on the policy as a Driver.
  • Manager - Strictly a manager, is NOT a Driver on the policy.
  • Other - Anyone besides the Owner / Management that has been authorized to contact us on their behalf, particularly to make modifications to their Policy / Coverages.

Truck(s) Information

VIN Year Make Model Actions
       
There are no Trucks.

Maximum number of trucks reached.

Do you have any trailers you want to insure?*

Trailer(s) Information

VIN Year Make Model Actions
       
There are no Trailers.

Maximum number of trailers reached.

Driver(s)

Do you have additional drivers?
Driver Name Date of Birth Drivers License # Drivers License State Actions
       
There are no Drivers.

Maximum number of drivers reached.

Commodities

What type(s) of commodities do you haul? The grand total of all commodities should equal 100%.
 
Add Commodity 2
 
Add Commodity 3
 
Add Commodity 4
 
Add Commodity 5
 
Add Commodity 6
 
Add Commodity 7
 
Add Commodity 8
 
Add Commodity 9
 
Add Commodity 10
 
This should equal 100%
If you haul other commodities not listed above, please enter them here.

Additional Insured(s)

Does anyone need to be listed as Additional Insured
If your AIs have documents or requirements you may upload those here.
Drop files here or
Accepted file types: pdf, Max. file size: 2 MB, Max. files: 10.
    Drop files here or
    Accepted file types: pdf, png, jpg, Max. file size: 2 MB.
      This field is for validation purposes and should be left unchanged.
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      Midwest Insurance Center

      944 U.S. Hwy 30
      Schererville, Indiana 46375
      Phone: 219-864-3333
      Fax: 219-864-9393
      Email: info@midwestic.com

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      Monday – Friday, 8:30am – 5pm CST

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