Omega insurance Services
Omega Insurance Services
"The end of your search for quality insurance"
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Please take a minute and complete the following information so we can give you a quote. This form can be emailed to us by clicking on the submit button below; or you can fax it to us at 661.326.6871; or you can call us at 661.326.6870; or you can mail it to us at 400 H Street; Bakersfield, California 93304.

Additional types of quotes available: General Quote | Worker's Compensation Quote

 

Commercial Auto Quote
Owner's Name:
Business Name:
Business Address:
City : State: Zip Code :
Phone: Fax:
Brief description of what the vehicle(s) is used for:
Liability Limit: $50,000 $100,000 $300,000 , $500,000
$1,000,000
Uninsured Motorist Medical Comp. & Collision
Deductible Amount: $250.00 $500.00 $1,000.00
Current Carrier:
Years in Business:
Claims in the last three years: Yes No

If yes, please list date of occurrance & the amount of
insurance the carrier paid out:

List the following information for all drivers operating vehicles:
Name
 DOB Driver's License
1.
2.
3.
4.
5.
List driver(s) having ticket/accidents within the last three years:
Vehicle ID:
Year:
Make:
Model:

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4700 Stockdale Highway Suite 125
Bakersfield, Ca 93309
Toll Free: 877-506-6342 Ph.: 661.326.6870; Fax: 661.326.6871

2001 Hexadecimal Designs