Hoya Insurance Agency

626-793-3800

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Trucking Quick Quote


Please fill out this form as completely as possible.  Unanswered questions may cause a delay in the quoting process.  If you prefer to speak with someone in person, or have a question about one of the items on the form, please call 626-793-3800 to speak to one of our friendly and knowledgeable associates.  You can submit this Form, as well as Vehicle Lists, Driver Lists, Loss Run Reports, IFTA Reports, MVRs, etc. via e-mail to: jean@hoyains.com or via fax at 626-793-3801.

Personal Information
First Name
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Last Name
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FMCSA #
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PUC#
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Company Name
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Company Owner
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Years In Business
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Street
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City
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State
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ZIP / Postal Code
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Primary Phone Number
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Fax Number
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E-Mail Address
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Garaging Address (if different)
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Carrier Type
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Type of Business
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Radius of Operation
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Cargo
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Average Cargo Value
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Maximum Cargo Value
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Trailers
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Do You Haul Hazardous Materials?
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If Yes, What Type?
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Do You Have Refrigerated Units?
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Do You Have Any Losses In The Last 3 Years?
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Requested Liability Limit
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Requested Cargo Limit
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Current Insurance Carrier
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Policy Number
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Annual Premium
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Previous Year Insurance Carrier Name
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Previous Year Policy Number
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Previous Year Annual Premium
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2nd Previous Year Insurance Carrier Name
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2nd Previous Year Policy Number
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2nd Previous Year Annual Premium
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Tractor #1 Year
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Tractor #1 Make/Model
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Tractor #1 VIN #
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Tractor #1 Gross Vehicle Weight
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Tractor #1 Current Value
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Tractor #1 Requested Deductible
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Tractor #2 Year
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Tractor #2 Make/Model
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Tractor #2 VIN #
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Tractor #2 Gross Vehicle Weight
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Tractor #3 Year
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Tractor #3 Make/Model
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Tractor #3 VIN #
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Tractor #3 Gross Vehicle Weight
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Tractor #3 Current Value
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Trailer #1 Year
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Trailer #1 Make/Model
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Trailer #1 VIN #
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Trailer #1 Gross Vehicle Weight
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Trailer #1 Current Value
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Trailer #1 Requested Deductible
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Trailer #2 Year
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Trailer #2 Make/Model
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Trailer #2 VIN #
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Trailer #2 Gross Vehicle Weight
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Trailer #2 Current Value
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Trailer #3 Year
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Trailer #3 Make/Model
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Trailer #3 VIN #
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Trailer #3 Gross Vehicle Weight
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Trailer #3 Current Value
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Driver #1 First Name
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Driver #1 Last Name
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Driver #1 License Number
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Driver #2 First Name
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Driver #2 Last Name
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Driver #2 License Number
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Driver #3 First Name
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Driver #3 Last Name
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Driver #3 License number
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What Is Your Target Premium?
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Please Select Other Insurance Products You Are Interested In
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

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Hoya Insurance Agency, Inc.
8812 E. Las Tunas Drive
San Gabriel, CA 91776
626-793-3800



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