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Wholesalers / Distributors Insurance Quote

Complete this risk questionnaire to receive a comprehensive insurance proposal for your wholesale or distribution business. All fields marked * are required.

Your submission will be reviewed by our team and processed through EZLynx for accurate quoting. We'll contact you within 1 business day.

Applicant Information

Business Legal Name*

DBA / Trade Name (if applicable)

FEIN / Tax ID*

Entity Type*

Business Mailing Address*

City*

State*

ZIP Code*

Business Phone*

Contact Email*

Contact Person / Owner Name*

Title / Position

Year Business Established*

Years Under Current Ownership*

Website URL

Vehicles & Transportation

Do you own or operate vehicles for business use?*

YesNo

Number of owned vehicles

Number of hired/non-owned vehicles used

Do you use forklifts or heavy equipment?*

YesNo

Do you use third-party carriers / freight companies?*

YesNo

Estimated annual freight / shipping costs ($)

Do you ship goods internationally?*

YesNo

Claims History (Past 5 Years)

Have you had any losses or claims in the past 5 years?*

YesNo

If yes, describe each claim (date, type, amount paid, status)

0/500

Have you ever been cancelled or non-renewed by an insurer?*

YesNo

If yes, explain

0/500

Current Insurance

Current insurance carrier

Current policy expiration date

Current annual premium ($)

Desired effective date for new policy*

Additional Information

Any additional information you would like us to know

0/500

By submitting, you agree to be contacted by an Advantixx licensed agent. Your information is secure and will be processed via EZLynx.

Wholesalers / Distributors Insurance Quote

Applicant Information

Operations & Products

Premises & Property

Vehicles & Transportation

Risk Management & Safety

Claims History (Past 5 Years)

Current Insurance

Coverage Requested — Select All That Apply

Additional Information