Fleet Vehicle Insurance Application Form
Company Information
Company Name
Contact Person
Phone Number
Email Address
Business Address
Fleet Details
Total Number of Vehicles
Types of Vehicles
Primary Use of Vehicles
Vehicle List
Year
Make
Model
VIN
Usage
Driver Information
Number of Drivers
Driver Hiring Criteria
Insurance Details
Current/Previous Insurer
Coverage Required
Any claims in last 5 years?
Yes
No
If Yes, please provide details