Insurance Agency Application
For agency appointment please complete the attached agency questionnaire and agreement.
Return with your Agency’s State Insurance License and a copy of your Agency’s E&O Declaration Page to
coryt@paulhanson.com
Agency Questionnaire (PDF Version)
Agency Agreement (PDF Version)
New Broker Video
A short video designed to provide real insight to our insurance broker network on all the highlights of the Biz Choice Last Mile Logistics Program.
Launch Video
Frequently Asked Questions
Frequently asked questions regarding the Last Mile Logistic Program
PDF Version
Broker of Record Procedures
Please see the attach which clarifies how Biz Choice Underwriters process “Broker of Record” letters.
PDF Version
Motor Carrier Supplemental Application
This supplemental application is to be used when providing a submission for a group of Independent Contractors working for one Motor Carrier. The intention is to create one motor carrier endorsed independent contractor insurance program
PDF Version
Independent Contractor Supplemental Application
This supplemental application is to be used when providing a submission for a single independent contractor operation. Please also provide a cover letter with a list of coverage types, limits and deductibles you would like quoted for auto liability, general liability, cargo, and umbrella.
PDF Version
Additional Driver/ Vehicle Information Supplemental Application Attachment
If the initial supplemental application does not provide enough space to list all the drivers and vehicle information please complete this form and attach it with supplemental application.
PDF Version
Last Mile Long Haul Radius Questionnaire
Only needed on account’s radius that exceeds 300 miles
PDF Version
Other Then Trucking/Last Mile Deliver Operation Supplemental Questionnaire
This supplemental submission questionnaire only needs to be completed if the operation is providing services outside the trucking or last mile delivery exposure.
PDF Version
Driver Eligibility Requirement
The attached form provides clarification of what is an acceptable motor vehicle record under this program and an owner’s signature will be required at binding.
PDF Version
Insurance Filing Request Form
Complete this form and provide to underwriting when an operation needs a specific insurance filing made on there behalf.
PDF Version