Commercial Auto Insurance Quote

We offer affordable commercial truck and car insurance premiums from
quality insurance companies to businesses in the following Connecticut
counties and cities: Fairfield County, New Haven County, Litchfield
County, Middlesex County, New London County, Hartford County,
Tolland County, Windham County, Stamford, Norwalk, Greenwich,
Darien, Riverside, Belltown, Springdale, Round Hill, Old Greenwich, East
Norwalk, New Canaan, Glenville, Byram, Cos Cob, Mianus, North
Stamford, Glenbrook, Wilton, Weston, Long Ridge, Noroton, West
Norwalk, Westport, High Ridge, Southport, North Wilton, Winnipauk,
Cannondale, Turn of River, South Wilton, Lyons Plains, Georgetown,
Ridgefield, Branchville, Redding, Topstone, Ridgebury, Redding Ridge,
Branchville, Dodgingtown, West Redding, Titicus, Hattertown, Bethel,
Danbury, New Fairfield, Newtown, Hawleyville, Botsford, Monroe,
Bridgeport, Stepney, Shelton, Huntington, Upper Stepney, Long Hill,
Trumbull, Stratford, Easton, Fairfield, Greenfield Hill, Stratfield, Nichols,
Oronoque, Rivercliff, Devon, Lordship, and East Bridgeport, New Haven,
Hartford, Torrington, Waterbury, Meriden, New Britain, New London,
Norwich, Manchester, East Hartford, Suffield, Granby, West Haven, West
Hartford, Branford, East Haven, Hamden, Woodbridge, Orange, North
Haven, Groton, Rocky Hill, Newington, Wethersfield, Glastonbury,
Bloomfield, Blue Hills, South Windsor, Naugatuck, New Hartford, Chesire,
East Lyme, Old Mystic, Wallingford, Southington, Middletown, Bristol,
Laurel Beach, Litchfield, Pleasure Beach, Mystic, North Westchester,
Double Beach, Willimantic, Storrs, Canaan, East Windsor, Vernon, South
Canaan, Putnam, Guilford, Windham, South Britain, Willington, Windsor,
East Hampton, Brooklyn, and Westchester, CT.

Information received from this Connecticut commercial auto insurance quote form sent to
Stamford Insurance Group will be for our use only and will not be sold, given to or distributed to
any other parties. A quote will be based on the commercial auto insurance information provided
and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to
meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as
issued. By submitting this request you acknowledge that this is neither an offer to insure nor a
guarantee of insurance. Completion of this form does not entitle you to Connecticut
Commercial Auto Insurance. We are licensed in Connecticut, New York, New Jersey,
Massachusetts, and Rhode Island. We will not provide quotes for other states.

Business Name:
Premises Address:
City:     State:     Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email Address: (Required)
Federal Employer's ID #:
Description of Operations or SIC code:

Vehicle     Year           Make                Model                 Body Type
     1
     2
     3
     4
     5

What type of air bag system is each vehicle equipped with?
Vehicle
     1
     2
     3
     4
     5

What type of anti-lock brake system is each vehicle equipped with?
Vehicle
     1
     2
     3
     4
     5

Does each vehicle have an alarm?
Vehicle
     1
     2
     3
     4
     5

                      Liability                    Uninsured                                             Collision         Comprehensive
Vehicle    Limits(x $1,000)      Motorist(x $1,000)       Medical              Deductible           Deductible
     1
     2
     3
     4
     5

                                  Drivers                          Date of                                              Drivers
Driver                       Name                               Birth                  Gender                 License #
     1
     2
     3
     4
     5

Is each employee's driving record accident & violation free during the past 5 years?
Driver
     1       If No, how many accidents?    How many violations?
     2       If No, how many accidents?    How many violations?
     3       If No, how many accidents?    How many violations?
     4       If No, how many accidents?    How many violations?
     5       If No, how many accidents?    How many violations?

Was any employee's driver's license suspended during the past 5 years?
Driver
     1
     2
     3
     4
     5

Other Insurance Company Used Within Past 3 Years:
Policy #:
Losses past 3 years:
Description of losses or loss runs:

Additional Information or Comments

Click on the "Submit Quote Information" button below to send your
Connecticut Commercial Auto Insurance quote request.