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Annual policy quote

Receive an annual policy quote from Borderless Coverage today.

Please fill out the form below so we can provide you with an accurate annual policy quote today. Borderless Coverage provides competitive quotes to support your business. To schedule a call, book a time on our calendar today.

General Information
Full Legal Name*
DBA (If Any)
Contact Name*
Contact Title*
Email*
Phone*
Fax
Website
Physical Address
Physical Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Mailing Address
Mailing Address
Street Address City State / Province ZIP / Postal Code Country
Company Information
FEIN#*
MC#
DOT#
Years In Business*
Business Structure*
- Corporation
- Individual
- Partnership
- Proprietorship
- Subsidiary
- Foreign
Corporation State*
Type of Business*
- Domestic Freight Broker
- Freight Forwarder
- Shipper
- Motor Carrier
- Other
Other Type of Business
Exposure History & Territory
Total Number of Annual Shipments to/from Mexico:
Total (previous year)
Estimated (current year)
Average Shipment Value:
Total (previous year)
Estimated (current year)
Maximum Shipment Value:
Total (previous year)
Estimated (current year)
Conveyances: (select all that apply)
- Truck
- Rail
- Vessel – Under Deck
- Aircraft
If you selected Truck, please provide percentages for each type of load:
LTL (Less Than Truckload):
Refrigerated:
TL (Truckload):
Oversized/Heavy haul:
Flatbed/Step deck:
Other:
Loss History
Please provide insurance company “loss runs” and cargo claims history for the last five years, including a description of the loss and whether or not funds were collected from the primary carrier/trucker. If a cargo loss was not collected from the carrier/trucker, did you make a settlement with the shipper or Consignee?
Loss runs, cargo claims
- Yes
- No
Please provide any claim details:
Upload Loss Runs
Upload Loss Runs
Drop files here

Max. file size: 15 MB, Max. files: 5.
Carrier Vetting
Check all that apply
- TAPA TSR Certified
- Use ISO Security Compliant Locks/Seals
- C-TPAT Certified
- Use GPS Tracking
- Enrolled in U.S. Customs Fast Program
- Dual-License for Transport in US/Mexico
- Protocols in Place for Unauthorized Stops/Route Deviation
Commodities
Commodities carried/arranged:
- Autos
- Boats
- Electronics (e.g., plasma tv’s, cell phones, iPods)
- Chemicals
- Explosives
- Furs or Leathers
- Jewelry
- Liquor
- Machinery
- Produce/Perishables
- Pharmaceuticals
- Seafood
- Food Products (Fresh)
- Food Products (Dried)
- Frozen or Chilled Meats
- Livestock or Live Animals
- Tobacco Products
- Computers
- Antiques or Art
- Clocks & Watches
- Household Goods or Personal Effects
- Non-Ferrous or precious Metals (copper, bronze, brass, aluminum, lead, nickel, tin, titanium, zinc, gold, silver, platinum, cobalt, mercury, etc.)
- Other (Describe in Detail)
Describe other commodities:
Integration
Are you interested in Integration?
- Yes
- No
What TMS do you currently use?
- Proprietary
- Third-Party
- Other
If Third-Party or Other, Which Provider?
Email
This field is for validation purposes and should be left unchanged.

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Borderless Coverage is a Reliance Partners' business. To learn more about Reliance Partners, please visit reliancepartners.com.