Skip to content
EmbedGravity Certs2026-04-24T18:59:47-04:00

*Trucking - Non-Fleet - Internal Use

"*" indicates required fields

1Basic Info
2Coverages
3Contacts
4Trucks
5Trailers
6Drivers
7Commodities
8Wrapping Up
This field is for validation purposes and should be left unchanged.
MM slash DD slash YYYY

Basic Information

Is your business currently insured?*
MM slash DD slash YYYY
Has the business either Currently or Previously operated under a DBA?
How is the business structured?*
Business Mailing Address*
Business Garaging Address
Are all vehicles garaged at the same location?*

Coverage Selection

Desired Coverages*
(Select all that apply)

Primary Contact

Primary Contact Name*
MM slash DD slash YYYY
Can we Text you?
Primary 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.
Is there a Secondary business contact?*

Secondary Contact

Secondary Contact: Name*
MM slash DD slash YYYY
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)

VIN Year Make Model Actions
       
There are no Trucks.

Maximum number of trucks reached.

This field is hidden when viewing the form

Trailer(s)

VIN Year Make Model Actions
       
There are no Trailers.

Maximum number of trailers reached.

This field is hidden when viewing the form

Driver(s)

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

Maximum number of drivers reached.

This field is hidden when viewing the form

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.
Loss Runs, Last 4 Quarters of IFTA's, MVRs, Driver List, Vehicle List.
Drop files here or
Accepted file types: pdf, png, jpg, Max. file size: 2 MB.
    Create Deal Card
    This field is hidden when viewing the form
    Consent
    Page load link

    Insurance Fraud Statement

    Fraud is a crime

    If your application contains purposefully misleading, absent, or inaccurate information, you could be charged with fraud. Your insurance carrier could potentially void your policy, or you could face civil or criminal charges or penalties.

    Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent act, which is a crime.

    Login

    Lost password

    Don’t have an account?

    Create AccountCreate Account
    Trux Insurance Services

    Talk to an agent: 331-240-1101

    Google Rating
    5.0

    Customer Reviews

    Free Consultation.
    Fast Quotes.
    Fully Covered.

    • 24/7 Certificate Portal
    • Multiple Quote Options
    • New Authorities Eligible
    • Auto Liability, Cargo, Physical Damage, Trailer Interchange, and more!

    Talk to an agent now

    331-240-1101

    Request a Quote

    It takes under 1 minute!

    "*" indicates required fields

    This field is for validation purposes and should be left unchanged.
    Can we text you?
    If not yet filed, enter "not filed"
    Business Address*
    We use cookies to offer you a better browsing experience, analyze site traffic and personalize content. Read about our Cookie Policy. Ok