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							How many shipments do you insure each month?    | 
							
							
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							Who are you currently insuring with:
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							From: | 
							
							
							
								
									
									
										
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							 Mode 
							of Transport  | 
							
							 
							
							
							 Carrier 
							Name  | 
							
							 
							
							Estimated Ship Date  | 
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							Package Count  | 
							
							 
							
							Package Type  | 
							
							
							Description of Items | 
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							Packaging:  | 
							
							
								
									
									
										
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									Insured Value: 
									    
									(Average Value of  
									each Shipment)  | 
									
									 
									$  | 
									
									 
								
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							Click 
							here to View and Compare Coverage Types  | 
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							How You Determined the 
							Value  | 
							
							 
							Comments/Additional 
							Info  | 
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							Name/Company  | 
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							Contact Info  | 
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							First/Last:  | 
							
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							 E-mail:  | 
							
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							Company:  | 
							
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							 Phone:  | 
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