NEMT Insurance Quote

NEMT Insurance QuoteAdmin2025-11-22T13:18:50-04:00

"*" indicates required fields

Company Name*

Number of Years in Business OR New Venure

Address, City , Zip Code*

Business Phone Number*

Email Address*

Radius of Operation*

List name of ALL drivers and date of birth and driver's license number*

List Year, Make, Model and VIN# of ALL vehicles and Value of each Vehicle*

Any claims in the past 3 years?*

Yes

No

Do you transport passengers on stretchers?*

Yes

No

Do you have DASH CAMS "camera" installed in each vehicle?*

Yes

No

Do you transport disabled people?*

Yes

No

Do you check new drivers for: driving records, criminal background, offensive sexual background?*

Yes

No

Is ALL transportation provided on Pre-Scheduled Pick-Up?*

Yes

No

Do you mandate employees to take Passenger Service and Safety (P.A.A.S) Training Program?*

Yes

No

Do you transport Unscheduled Passengers, EX: Airport-Market-Events-Shopping?

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501 E. Las Olas Blvd, Ste#300

Fort Lauderdale, Florida 33301