Rivington Partners Transportation - Bind Request

* indicates required field

Bind Requirements:

• Completed Vehicle and Driver Spreadsheet
• Signed Rivington Application
• Signed UM/UIM coverage selection/rejection form
• Signed COE/Affidavit/Dilligent search form
• Any endorsement/exclusion that requires an insured’s signature
• Completed Quote
• Boxtruck Verification Form
• Authorization Form to Obtain Consumer Reports & Insurance Based Credit Score

Note:
If you scanned 2 or more documents into a single file, please upload the file into each of the corresponding form's upload link.

BIND

Bind: *

UPLOAD FILES


Bind LIABILITY Option: *
 


Bind PHYSICAL DAMAGE Option: *
 
















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