Request A Quote

TRANSPORT INSURANCE AGENCY, INC.
5215 Monroe Street, Suite 15
Toledo, Ohio 43623
Fax 419-841-5966
E-Mail: quotes@4tia.com

We are an Independent Agent with access to various companies across the country. A one-stop shop for you!

Fill in and submit the form below, and we will call you at your convenience.

GENERAL INFO
Name:
Phone:
Best Time to Call:
Email:
Insured:
Business Owner:
Current Policy Expires:
Garaging City/State/ZIP:
 
COMMODITIES

Please list all commodities that you haul, followed by the percentage that commodity represents to the total you haul.
Example: Appliances 50%, Produce 25%, Electronics 25%

 
OPERATIONS
List in miles the radius you haul:
Do you have Federal Highway Authority? Yes No
Do you use Owner Operators? Yes No
Do you permanently lease to others? Yes No
Do you trip lease to other ICC Carriers? Yes No

List all MAJOR cities operated into or through:

We will also need the following information.
Please email it to quotes@4tia.com or Fax it to (770) 717-9511.

• Prior Insurance History for the last 3 years
• Loss History for the last 3 years
• Name, D.O.B., Drivers License Number w/ State of Issue, Years Experienced, and
  Original CDL Date of all drivers
• Accident and Violation history for ALL drivers for the last 3 years
• Year, Make, Type, VIN, and Stated Value of all vehicles