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Motor Carrier Submission Requirements

(All information must be complete for quotation)
  • Acord Application 125 (General Commercial Application)- PDF Version
  • Last Mile Supplemental Application – PDF Version PDF Version
  • Acord Application for each coverage requested for quotation
    • Workers Compensation
    • Business Auto
    • Property
    • Commercial General Liability
    • Umbrella Liability
  • Complete Vehicle Schedule (including Radius & VIN #’s)
  • Drivers List (Driver’s Name, License #, Driver’s License Issuance State, DOB)
  • Three Year Hard Copy Company Loss Runs
  • Number of Years in Business
  • 4 Years Historical Vehicle Count
  • Financials
  • Insured email, website address and FEIN #
  • Last Mile Long Haul Questionnaire (Complete on account radius exceeds 300 Miles) – PDF Version
NOTE:  Please send all email submissions to lastmile@paulhanson.com. Or, you can fax your submissions to (707) 252-5905, C/O the Biz Choice Last Mile Logistics Program.