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Oklahoma City, OK 73154
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Back to Express Requests
*Complete and submit the form below for an Express Premium Indication from OGA’s Small Business Unit
Fax: 405.840.9388 | 800.771.8116 Phone: 405.840.9393 | 800.299.1951
Please list each as: Commodity | Percentage of Loads | Maximum Value | Average Value
E.G.: Copper | 25% | $30,000 | $15,000
Describe the usual route(s) including largest city entered
Please list each as: Company Name | Policy Date | Policy Number | Premium | Number of Units
E.G.: Company X | 10/05/2011 | 121222 | $20,000 | 5 Units
Include 3 year history
If yes, Hired & Non-Owned supplemental form is required.
Will need non-driver payroll.
If yes, copy of Trailer Interchange Agreement is required.
Must be current market value
*Fully completed company specific applications and any applicable supplemental questionnaires are required prior to binding. The premium may change upon receipt of company applications and required supplementals.