Almost there

Tell us about your business

The full trailer rental questionnaire, broken into eight short steps. Have your fleet list and current policy handy.

Owner contact

First Name Last Name

Title Email Address

Phone Number Mobile Number

Best Time to Contact

Business information

Business Name (Legal) DBA (if applicable) Business Structure

Federal Tax ID / EIN Years in Business

Website Physical Address

City State ZIP

Mailing Address (if different)

Trailer inventory

Total Number of Trailers in Fleet Total Replacement Cost Value ($)

Rentals per Month Overall Fleet Mix

Are your trailers stored at the business address listed above?

Yes No

Tell us where the fleet is kept — storage location drives a large part of the rate.

Storage Address

City State ZIP

Trailer details

List up to five trailers here. Running a bigger fleet? Check the box at the bottom and we'll collect the full schedule by email.

Trailer 1 Complete

VIN Make Model Year Type Replacement Cost ($)

Trailer 2 Complete

VIN Make Model Year Type Replacement Cost ($)

Trailer 3 Complete

VIN Make Model Year Type Replacement Cost ($)

Trailer 4 Complete

VIN Make Model Year Type Replacement Cost ($)

Trailer 5 Complete

VIN Make Model Year Type Replacement Cost ($)

I have additional trailers beyond the five listed above

Current insurance

Current Insurance Carrier Policy Number

Policy Effective Date Policy Expiration Date

Expiring Annual Premium ($)

Agent / Broker Name Agent / Broker Phone

Loss history

Currently valued loss runs available (past 5 years required)

We'll request the loss runs by email once your quote is under way — nothing to upload here.

If no loss runs are available, explain

Revenue

Gross Annual Sales from Trailer Rentals ($)

Period From Period To

Projected Gross Annual Rental Sales, next 12 months ($) Anything else we should know?

Warranty statement

I hereby warrant that the statements and information provided in this application are true, complete, and correct to the best of my knowledge and belief. I understand that this application will become part of any insurance policy issued and that any misrepresentation, concealment, or incorrect statement of material fact may result in the denial of coverage or cancellation of the policy. I agree that if any of the information provided herein changes prior to the effective date of insurance, I will immediately notify Trailer Guard Insurance in writing of such changes. This application does not bind the applicant or Trailer Guard Insurance to complete the insurance, but it is agreed that this application shall be the basis of the contract should a policy be issued.

I have read and agree to the warranty statement above.

Signature — type your full name

Title Date

Typing your name here counts as your electronic signature on this application.