Pedicab Insurance

In order to receive the most accurate quote, please answer the following questions as best you can. Coverage can only be calculated after receiving a fully completed form.

Company Name
Owner Name
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Requested Effective Date / MM / DD YYYY
Email- Be sure to fill this field out so that we can send you your quote!
Phone- Be sure to fill this field out so that we can send you your quote! - (###) - ### ####
Years in Business
Number of Pedicabs/Rickshaws
Prior Insurance Company
Current Premium
Number of Claims in the Past Three (3) Years
Dollar Amount of Claims Paid in the Last Three (3) Years
Are independent contractors used? Yes No
Are all operators over the age of 18? Yes No
Briefly Describe Your Driver Hiring Procedure
**Please Note** We will need we will need a copy of your driver agreement and/or employee handbook faxed to 617-964-1888 or emailed to sbaratz@massinsurers.com.

Please click the "Submit" button below. We will return your completed report in 24 hours or less.
If you have any questions or comments, please email us at sbaratz@massinsurers.com or call us at (617) 965-1777.