Property and Casualty Insurance Application

Please email or fax a copy of your lease, and currently valued loss runs (or a signed statement of no loss.) The loss runs or signed statement will be required to quote.

Fax #: 830-755-2484 • Email: Amber Mclane | amclane@onthemovetrucks.com

Applicant Details
Mortgagee/Loss Payee
Employee Dishonesty
Location Details

Building 1

Building 2

Building 3

Building 4

Building 5

Additional Questions
Building Updates
Sale & Disposal Legal Liability
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Agreement I BELIEVE THE STATEMENTS IN THIS APPLICATION ARE TRUE AND CORRECT. I UNDERSTAND THAT THE INSURER WILL RELY ON THESE STATEMENTS IF A POLICY IS TO BE ISSUED. PROVIDING FALSE INFORMATION ON AN APPLICATION FOR INSURANCE IS FRAUD WHICH IS A CRIME IN MANY STATES.
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