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SOL Insurance Agency
1370 W. Flagler Street
Miami, FL 33135
 
Toll Free: 888-476-5467
Phone: 305-643-2333
Fax: 305-541-0608

Insuring Florida
Residents & Businesses

On-Line Taxi, Limosine or shuttle bus Quotation Form
One Simple Form - takes only 2-3 Minutes!
Or call us now at (305) 643-2333

YOUR PERSONAL DATA:

Your Name: (First & Last)
Business Name:
Street Address:
City:
State: (Must be Florida)
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If no, type NONE)
 
Type of Business:


 
DRIVER INFORMATION #1
(if more than two drivers,
list in remarks)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Drivers License #: Hack License #:
If none leave blank
Airport delivery:
Yes or No
Length of shift?:
Number of taxi
stops per day:
Comments or
Remarks?
 
DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Drivers License #: Hack License #:
If none leave blank
Airport delivery:
Yes or No
Length of shift?:
Number of taxi
stops per day:
Comments or
Remarks?


COMMERCIAL VEHICLE #1:
If more than 2 vehicles, list in remarks
or call us at: 888-476-5467
Year of vehicle: Make:
Model: # of seats:
Metered?: Y or N Cost New: $
Radius of operation: miles How long is shift?:
Number of shifts for vehicle

VEHICLE ID#
(highly suggested for accurate rating)

VEHICLE #1 COVERAGES:
Limits of
Liability:
$125/250/100 (minimum)
$300,000 CSL
$500,000 CSL
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
COMMERCIAL VEHICLE #2:
Year of vehicle: Make:
Model: Number of seats:
Metered?: Cost New:$
Radius of operation: How long is shift?:
Number of shifts for vehicle

VEHICLE ID#
(highly suggested for accurate rating)



VEHICLE INFORMATION FOR UNITS #3-5:
(If none, Leave Blank)
VEHICLE #3
(List Year, Make, Model & Value)
VEHICLE #4
(List Year, Make, Model & Value)
VEHICLE #5
(List Year, Make, Model & Value)


VEHICLE #2 - #5 COVERAGES:
Limits of
Liability:
$125/250/100 (minimum)
$300,000 CSL
$500,000 CSL
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

 
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Taxi Insurance Quote NOW!


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