Commercial Auto
Insurance Quote
We provide comprehensive Commercial Auto
Insurance services throughout New Jersey!
In addition to Commercial
Auto Insurance, we also offer
affordable Business Liability
Insurance plan services.
Business Name:    
Premises Address:
City:
State:  (New Jersey, Pennsylvania or New York)
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 Jersey 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             Tort Option
     1                   
     2                   
     3                   

New Jersey 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 Jersey Commercial Auto Insurance quote request.**

**Information received from this New Jersey Commercial Auto Insurance quote request
form sent to New Penn Insurance Associates, 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 Jersey Commercial Auto
Insurance Policy. We are licensed in New Jersey, New York, Pennsylvania, and will not
provide quotes for other states.


Business Information:
Copyright 2006-2008 New Penn Associates, LLC - All rights reserved
Site Built & Maintained by InsuranceWebsiteServices.com
"Proudly serving New
Jersey, Pennsylvania and
New York since 1982"
Auto - Home - Health - Business
NEW PENN
INSURANCE ASSOCIATES
New Penn Insurance Associates
83 Princeton Avenue
Suite 3D
Hopewell, New Jersey 08525
Mercer County, NJ
(609) 466-5300
Toll Free: (800) 927-7475
Fax: (609) 466-7289
New Penn Insurance Associates
538 Street Road, Suite 200
PO Box 578
Southampton, PA 18966
New Penn Insurance Associates
of Hopewell, NJ offers
comprehensive Commercial
Insurance coverage options and
experienced business insurance
services throughout New Jersey
and Pennsylvania.
Contact us about Property,
Group Health, Auto, and
Liability Insurance for your New
Jersey or Pennsylvania business
at 609-466-5300.
(New Jersey & Pennsylvania)