Marine Cargo Insurance - ENG

1 GENERAL INFORMATION

MARINE CARGO INSURANCE QUOTE

Company NameFull Business Legal Name

Full NamePoint of Contact for Company

E-maila valid email

Types of merchandise that you handle for your clientsfor example electronics, clothes, hardware, lumber, etc.

Average value of shipments that are insurableIn dollars ($)

Common places of Origin & Destinationfor example USA, Guatemala, Mexico, etc.

Please write out the percentage (%) of mode of transportation you usually use. Please put 0 if not used.

Air

Maritime

International Terrestrial

Do you have a current Provider for International Cargo Insurance?If so, select yes, and state the name of your current provider

YesNo

Name of Current Providerif you have a current provider for International Cargo Insurance

Target Rates & ConditionsWe want to offer you favorable and attrative rates/conditions that can adapt to your needs.