NH Commercial Auto Insurance Quote

We are your local southeastern New Hampshire, southern Maine
insurance agency, offering experienced commercial auto insurance
services to businesses located in the following cities and counties:
Somersworth, Durham, Portsmouth, Dover, Rochester, Rollinsford,
Barrington, Madbury, Lee, Strafford, Farmington, Milton, Barnstead,
Nottingham, Northwood, Raymond, Newmarket, Newfields, Stratham,
Rye, Hampton, Epping, Exeter, Salem, Danville, Deerfield, West Rye,
Derry, Chichester, South Barnstead, Gilmanton, New Durham,
Wolfeboro, Alton, Laconia, Berlin, Lebanon, East Candia, North
Hampton, Hanover, Littleton, Plymouth, Claremont, Newport, Keene,
Hampton, Rye Beach, Strafford County, Rockingham County,
Hillsborough County, Merrimack County, and Belknap County, NH. We
also offer commercial auto insurance services throughout the state of
New Hampshire, including the Manchester, Nashua, and Concord area.
Our service area in southern Maine includes the following cities and
counties: South Lebanon, Kittery, Eliot, Berwick, Sanford, Blaisdell
Corners, Springvale, Emery Mills, Wells Beach, York Beach, Kittery
Point, Kennebunk, Saco, Biddeford, Alfred, Portland, Scarborough,
Westbrook, Waterboro, Shapleigh, Newfield, Buxton, Goodwins Mills,
South Sanford, Cape Elizabeth, South Portland, York County, and
Cumberland County, ME.

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

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

New Hampshire 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

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 New Hampshire Commercial Auto Insurance quote request.**

**Information received from this New Hampshire Commercial Auto Insurance quote request form sent to Gorman Insurance and Risk Management 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 commercial auto insurance policy 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 New Hampshire Commercial Auto Insurance Policy. We are licensed in New Hampshire, Maine, Massachusetts, and will not provide quotes for other states.