Start Quote - Global Guard Insurance

ZIP Code *

Please choose what best describes your business. *

Let’s get a little more detail. Please pick what kind of contracting or construction business you have. *

Let’s get a little more detail. Please pick what kind of on-demand services (Uber, Lyft, Amazon, etc.) you do. *

Let’s get a little more detail. Please pick an option that fits your business type. *

Let’s get a little more detail. Please pick an option that fits your social services or non-profit organizations business. *

Let’s get a little more detail. Please pick an option that fits your transportation, trucking, or towing business. *

Which of the following companies do you drive for (select all that apply)? *

Uber
Lyft
ZipCar
Other transportation network company (TNC) not listed
I do not drive for an on-demand or TNC

How long have you driven for them? *

I haven't started yet
Less than 3 months
3 to 6 months
6 to 12 months
1-2 years
More than 2 years

Is ridesharing your main source of income? *

Type of Business *

Industry Type *

Industry *

Industry Type *

Industry *

Industry Type *

Industry *

Industry Type *

Business Info

Business Owner Name *

First

Last

Company Name *

Phone *

Email Address *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are all vehicles regularly parked overnight at the above address? *

Please Input Garaging Address *

Address Line 1

Address Line 2

City

State

Zip Code

Do you have a Global Guard insurance policy? *

Global Guard Policy Number *

How long have you been a Global Guard policyholder? *

Please Select

Business Ownership Type *

Please Select

Business Name *

How long have you been in your current business? *

Do you currently have auto insurance? *

How long have you been with your current auto commercial insurance company?? *

How long have you been with your current auto commercial insurance company? *

When did your most recent commercial auto insurance end? *

Why haven't you needed auto insurance? *

Did you have insurance prior to being deployed? *

What year is your vehicle? *

Make *

Model *

Who is registered owner of the vehicle? *

First

Last

Registered State *

Vehicle Ownership *

Has the vehicle been customized or modified in any way? *

How much are your customizations or modifications worth? Please put a dollar amount. *

What is the main purpose of this vehicle? *

How many miles do you regularly travel from where the vehicle is garaged (radius of operation?) *

Do you use this vehicle mainly to carry tools or equipment to job sites for your work? *

Who is the main driver of this vehicle? *

Do you need to add another commercial vehicle or trailer? *

What year is your second vehicle? *

Make *

Model *

Who is registered owner of the second vehicle? *

First

Last

Registered State *

Vehicle Ownership *

Has the second vehicle been customized or modified in any way? *

How much are your customizations or modifications worth? Please put a dollar amount. *

Is the second vehicle only used for commuting to work or school? (Never used to travel to job sites or for other business uses.) *

How many miles do you regularly travel from where the vehicle is garaged (radius of operation)? *

Do you use this vehicle mainly to carry tools or equipment to job sites for your work? *

Who is the main driver of this vehicle? *

Name *

First

Last

Date of Birth *//

What is this driver's relationship to the business? *

Has this driver been licensed for at least 5 years? *

Employee Information

How many employees do you have, including part time employees? *

(Do not include yourself or partners.)

Does your business do employee drug testing and or criminal background checks? *

We need some info on driver training. As a business, do you offer employee driver training or some sort of accident prevention programs? *

Do you carry worker’s compensation insurance coverage for your drivers? *

How many people will drive your vehicles? *

Please include yourself, employees, and other household members.

Do you need to add any drivers? Please add all owners as drivers. *

Name *

First

Last

Name *

First

Last

Name *

First

Last

Has any driver had any of the following? *

Accidents (regardless of fault) within the last 3 years
Traffic convictions within the last 3 years
Traffic convictions for DUI/DWI, reckless driving, or driving on a suspended license within the last 5 years
NONE

Coverage Information

What bodily injury limits do you currently have on your vehicle insurance? *

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Employee Information

Coverage Information

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