Georgia Commercial Auto Insurance Quote

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

Georgia Vehicle Information:

Vehicle     Year              Make              Model             Body Type
     1
     2
     3

Additional Vehicle Information:

                Miles          Cost                                     Where              Lienholder      Lienholder
Vehicle   Driven         New            VIN#               Garaged              Yes/No             Name
     1
     2
     3

Georgia Commercial Auto Insurance Coverage Information:

                      Liability                 Property                   Uninsured
Vehicle  Combined Limits          Damage               Combined Limits         Medical
     1
     2             SAME                       SAME                       SAME                   SAME
     3             SAME                       SAME                       SAME                   SAME

                   Collision         Comprehensive
Vehicle    Deductible           Deductible
     1
     2
     3

Georgia Driver Information:

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

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?

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

Recent Insurance Information:

Current Insurance Company:
Expiration Date: (mm/dd/yyyy)
Any losses past 3 years:
Description of losses, including amount paid on each accident:

Additional Information or Comments

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

**Information received from this Georgia Commercial Auto Insurance quote request form
sent to JRS Risk Services 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 Georgia 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 your business to a Georgia Commercial Auto
Insurance policy. We are licensed in Georgia and will not provide commercial auto
insurance quotes for other states.

Georgia Commercial

Auto Insurance Quote

We can provide comprehensive Georgia

Commercial Auto Insurance coverage services

in the Atlanta, GA area and throughout Georgia!

JRS Risk Services of Atlanta,
GA offers comprehensive
commercial insurance coverage
options and experienced
business insurance services
throughout Georgia.

Contact us about Georgia
Business Liability, Commercial
Auto, Business Owners,
Professional Liability, and
Business Property Insurance at
(678) 921-4650.

In addition to a Georgia
Commercial Auto Insurance
quote, we also offer affordable
Commercial Property
Insurance plan quotes.

We are an Atlanta, GA insurance agency offering comprehensive Georgia
commercial auto insurance quotes to businesses in the following cities and
counties in Georgia: Smyrna, Douglasville, Vinings, Oakdale, Sandy Springs,
Marietta, Riverside, Carey Park, Adamsville, Bolton, Center Hill, Grove Park,
Buckhead, Morningside, Fair Oaks, Privette Heights, Dunwoody, Chamblee,
Doraville, Skyland, Brookhaven, Embry Hills, Oak Grove, Rehoboth, Vista
Grove, East Marietta, Toco Hills, North Druid Hills, Decatur, Scottdale,
Clarkston, Belvedere, Pendley Hills, South Decatur, Druid Hills, Gresham
Park, Avondale Estates, Panthersville, North Decatur, Cedar Grove, Conley,
Forest Park, College Park, East Point, Stockbridge, Morrow, Riverdale,
Stone Mountain, Union City, Mableton, Lithia Springs, Winston, Douglasville,
Austell, Powder Springs, Hiram, Dallas, Kennesaw, New Hope, Kennesaw,
Acworth, Woodstock, Roswell, Alpharetta, Norcross, Duluth, Gainesville,
Buford, Auburn, Winder, Cartersville, Rome, Cedartown, Peachtree City,
Buckhead, Canton, Cumming, Braselton, Sugar Hill, Hoschton, North
Atlanta, Tucker, Pine Lake, Mountain Park, Glen Haven, Belmont, Redan,
Pittsburg, Lilburn, Luxomni, Snellville, Five Forks, Centerville, Whitney,
Pannell, Lithonia, Dialtown, Flint Hill, Conyers, Milstead, Klondike, Panola,
Snapfinger, Magnet, Gloster, Bethesda, Pleasant Hill, Pittman,
Mechanicsville, Meadow, Berkeley Lake, Lawrenceville, Forest Hills,
Suwanee, Northwoods, East Lake, East Atlanta, Oakhurst, La Vista,
Brookhaven, Doraville, Fulton County, Dekalb County, Forsyth County,
Gwinnett County, Walton County, Newton County, Paulding County, Douglas
County, Cherokee County, and Cobb County, GA. We also offer experienced
Georgia commercial auto insurance plan quotes throughout the Peach state,
including in Macon, Columbus, Augusta, Athens, and Savannah, GA.

Any questions about

Georgia Commercial

Auto Insurance?