Wasatch Preferred Commercial Auto

Commercial Auto

We understand you’ve worked hard to make your business succeed, so we work hard to help you protect it. Wasatch Preferred represents over a dozen companies, so whether you need to insure your business and vehicles from damage, your employees from injury, or yourself from lawsuits, the Insurance Planners at Wasatch Preferred will help you get the right coverage in place. Call us at 801-676-7101 or complete the form below for personalized service with all your commercial insurance needs.

Company Name	Industry Type

Contact First Name	Initial	Last Name

Address

City	State	Zip

Day Phone	Night Phone	Fax

Best Time To Call A.M. P.M.

Email Address

Drivers

Driver 1

First Name	Initial	Last Name

Marital Status Male Female

Date of Birth State Licensed

Driver's License Number

License Type

Driver 2

First Name	Initial	Last Name

Marital Status Male Female

Date of Birth State Licensed

Driver's License Number

License Type

Driver 3

First Name	Initial	Last Name

Marital Status Male Female

Date of Birth State Licensed

Driver's License Number

License Type

Driver 4

First Name	Initial	Last Name

Marital Status Male Female

Date of Birth State Licensed

Driver's License Number

License Type

Vehicles

Violations

Tickets in the last 3 years, Accidents in the last 5 years

	Driver 1	Driver 2	Driver 3	Driver 4
Tickets
At Fault Accidents
Major Violations - DUI, hit & run, etc.

Coverage

Coverage Amounts

	Bodily Injury	Property Damage
Commercial Liability
Uninsured Motorist
Underinsured Motorist
Medical

Currrent Insurance Company

Expiration Date

I am also interested in

Commercial Liability/Property Workers Compensation Inland Marine Crime Insurance Pollution Coverage Directors & Officers
Business Interuption Personal Lines of Insurance

Questions or Comments

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wasatch preferred

Commercial Auto

Drivers

Vehicles

Violations

Coverage