BUSINESS ELECTION *
YOUR FLEET
 % of the fleet for
Pleasure
Business
Military
Ins. Replacement
 % of the fleet
New Cars
Used Cars
Pickup Trucks
Cargo Vans
 % of the fleet
7 Pass Vans
15 Pass Vans
Convertibles
Electric
This application may not be used to bind coverage and no coverage commences: Completion of this application by a prospective insurance buyer is for the purpose of transmitting information only.  Any agreement or contract binding insurance coverage must be done on a separate document.  Coverage will commence only upon the effective date of a separate contract binding insurance coverage issued by an agent authorized by the company.  
 
 
Signature:   I declare to the best of my knowledge that all statements herein are true and no material facts have been suppressed or misstated.  I am also aware that my operation may be inspected by the insurance company.  In addition, I authorize any prior insurance carrier to release underwriting and claim information to GMI for the purpose of qualifying my business for the coverages requested.
 
 
Please sign with your mouse or finger *
clear
Yes, I am interested in getting a quote for insurance. I realize that Auto Rental Solutions is a consulting group and will assist me in getting the proper insurance for my rental car location. I agree to pay the fee of $186.00 for their assistance in finding the proper carrier for my company. Click on the circle below *