International Trade Quote

For a free quote relating to your International Trade, please submit this form with your name and company information, and include a description of your company's insurance needs, and commodity and shipping characteristics. We will return a quote as quickly as possible via Internet or fax.

Yes! Please contact me, and give me a quote for insurance coverages!

Contact Information

Name	Company
Street Address
City State or Province Zip Code
Country	Email
Phone Number	Fax Number
Nature of the Business (Manufacturer, Distributor, Commodity Broker, etc.)

Policy Information

Type of Policy Open Policy

Trip Risk

One-Year Term

 

Geographical Limits U.S. to World	World to U.S.	World to World
Other:
Valuation Amount of Invoice, including Charges, Plus Ocean Freight, Plus 10%
Other:
Insuring Conditions All Risks	Free of Particular Average
Other:

Commodity Information

Principal Merchandise to be Insured

Packing (Describe in Detail)

Limits of Insurance

By Any One Vessel	By Any One Domestic Conveyance
By Any One Vessel On Deck	By Any One Barge
By Any One Aircraft	By Parcel Post (US Mail)
Government Rejection per B/L or Entry

Insured Volume

	Export	Import	Domestic
Past 12 Mos
Est. Next 12 Mos.
Est. Avg. Value Per Shipment

Warehousing

Address	Description	Limit	Average
1
2
3
4

Overseas Supplier Certified Locations (If Gov't Rejection coverage is desired)

Name	Address
1
2
3
4

Geography

Principal Countries to which Goods are Exported (Indicate % involved)

Principal Countries from which Goods are Imported (Indicate % involved)

Current/Expiring Policy Information

Current Insurer	Agent
Current Premium Rate %:	Estimated Annual Premium $
Loss Information (Countries, Amount, Description of Loss)

Remarks

Comments

Please type the word appearing in the box to the right:

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For additional information call us at (800) 350-5647, fax a request for quotation to (714) 430-0036, or contact us.