FIF Underwriting

Your Company Name:*

Your Name:*

Your Email:*

You are:*

SHIP DATE:*

Named Insured - OWNER OF THE GOODS (Cannot be Motor Carrier or Freight Broker):*

Commodity Full Description:*

Shipment contains (Select any that apply):

New/Used:*

If USED Vehicle or Equipment provide year

FTL/LTL:*

OS/OW:*

Weight*

Height*

Pieces*

Equipment:*

Shipment Packed by

Describe Packaging:*

Shipment Origin, City and State:*

Destination City and State:*

How many overnight stops:*

Full Value of the load based on the BOL/Commercial Invoice:*

Motor Carrier Cargo Limit (this becomes the deductible):*

Motor Carrier Name:

Freight Broker Name:*

Will this load be posted on a load board?*

Do you use a Vetting Service?*

Name of Vetting Service*

Security Protocol (describe all security measures taken):*

Upload Photos -if available

Drop files here or

Max. file size: 50 MB.

Notes to Underwriter - Details can help procure approval:

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