Great Insurance Values.com brought to you by Lakhani Insurance Agency, Inc.

f Great Insurance Values.com brought to you by Lakhani Insurance Agency, Inc.

Lakhani Insurance Agency, Inc.

Individuals, Families & Groups
Life Insurance
Health Insurance
Group Insurance
Dental Insurance
Medicare Supplement
Disability Income
Long-Term Care
Retirement Accounts

Business Owners, Self-Employed
General Liability
Commercial / Business Ins.
Commercial Auto Insurance
Commercial Property
Umbrella Insurance
Employment Practices
Lessor's Risk
Workers Comp

Medical & Dental Professionals
Medical Malpractice

Garage Liability
Auto Dealers
Auto Repair / Body Shops

Professional Liability
Engineers
Attorneys

Surety Bonds
Auto Dealer Bond
Construction Bond
Contract Bond
Performance Bond
Subdivision Bond
Contractor License Bond
Insurance Brokers Bond
License & Permit Bond
Mortgage Broker Bond
Payment Bond
Probate Bond
Sales Tax Bond
Miscellaneous Bonds

Commercial Auto Insurance

A commercial automobile insurance policy is required under most circumstances when the vehicle is being used for business purposes. It is not just the registration that determines the requirement for a business automobile insurance policy. Other requirements are ownership by a corporation, use in hauling goods for hire and gross vehicle weight of the vehicle. Some small trucks, however, can be owned and insured under a personal automobile insurance policy under specific circumstances.

Name:	(required)
Email:	(required)
Phone:
Preferred contact:	phone email
Business Name:
Company Type:	sole owner partnership corp.
Address:

	Driver 1
Name:
Date of birth:
Years licensed:
	Vehicle 1
Year, make & model:
Annual mileage:	(estimated)
Operating radius:
Garaging ZIP code:
	Driver 2
Name:
Date of birth:
Years licensed:
	Vehicle 2
Year, make & model:
Annual mileage:	(estimated)
Operating radius:
Garaging ZIP code:
Include the same information for any additional drivers:
Include the same information for any additional vehicles:


Coverage / limits desired:
Bodily Injury Liability:
Property Damage Liability:
Medical Payments:
Uninsured / Underinsured:
Comprehensive deductible:
Collision deductible:


Coverage options:
Uninsured motorist property damage	yes no
Towing	yes no
Rental reimbursement	yes no
Waiver of collision deductible	yes no


If you already have coverage, please list provider, expiration date and annual premium range: