This supplemental application is to be used when providing a submission for a group
of Independent Contractors working for one Motor Carrier. The intention is to create
one motor carrier endorsed independent contractor insurance program
This supplemental application is to be used when providing a submission for a single
independent contractor operation. Please also provide a cover letter with a list
of coverage types, limits and deductibles you would like quoted for auto liability,
general liability, cargo, and umbrella.
If the initial supplemental application does not provide enough space to list all
the drivers and vehicle information please complete this form and attach it with
Only needed if account's radius exceeds 300 miles
This supplemental submission questionnaire only needs to be completed if the operation
is providing services outside the trucking or last mile delivery exposure.
The attached form provides clarification of what is an acceptable motor vehicle
record under this program and an owner’s signature will be required at binding.
Complete this form and provide to underwriting when an operation needs a specific
insurance filing made on their behalf.
Change Request Form - Existing Contract Carrier
It is your responsibility to notify BizChoice directly to cancel any insurance coverage.