GET YOUR FREE QUOTE
Two ways to request a truck insurance quote:
1. Call our agent at 773-654-1079 for an instant quote or ;
2. Fill out and submit the form below
Note: we will never share your personal information or phone number with an outside company or agency.
*Name:
*Street Address:
*City:
*State/Province:
*Zip/Postal Code:
Work Phone:
Home Phone:
FAX:
Equipment Year and Make:
Unit 1:
Unit 2:
Unit 3:
Driver's Name:
Tickets:
Accidents:
Limits of Liability:
Amount of Cargo Insurance:
Amount of Physical Damage coverage on equipment:
Please check off the coverages for which you are requesting:
Primary Liability
Trailer Interchange
Workman's Comp
ICC Authority
Bobtail Liability
Physical Damage
Motor Truck Cargo
Do you have ICC Authority?
Where did you hear about us?
Questions/Comments?:
MC Number:
Just hit Submit once and your information will be sent to our processing center. This process may take a few seconds.

Contact Us

  1. 5214 North Western Ave. Suite 202,  
  2. Chicago, IL 60625
  3. Phone:  773-654-1079
  4. Fax : 773-989-1127
  5. E-mail:  almira@affinityinsure.com

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