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Get Motor Truck Cargo Application

DDRESS (number, street, city, state, zip) AGENT OR BROKER WEBSITE TELEPHONE ( ) PRODUCER CODE - ext. FAX ( ) - BUSINESS INFORMATION NATURE OF BUSINESS (manufacturer, wholesaler, retailer, etc.) How long in business? Years Any other policies with Fireman's Fund? PRINCIPAL MERCHANDISE TO BE INSURED (enclose pictures or illustrated catalog, if available) TOTAL GROSS SALES (previous 12 mo.) $ ESTIMATED GROSS SALES (next 12 mo.) $ GENERAL INFORMATION COVERAGE SECTIONS: Marine Cargo.

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