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Years in Business*
Number of employees & volunteers
What type of transportation are you engaged in?
- Non-emergency medical transport
- Emergency transportation
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Percent of calls for paratransit / wheelchair
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Percent of calls for ambulances
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Ambulance Info
Number of Ambulances / Paratransit Vehicles*
Number of Vehicles in Your Fleet*
Be prepared to provide a schedule of your vehicles
Year*
Make*
Other Make
Driver Info
Number of Drivers*
2+ Years CDL?*
- Yes
- No
Driver is Over 25?*
- Yes
- No
Number of Drivers in Your Fleet*
Be prepared to provide a schedule of your drivers
Contact Info
Company Name*
ZIP / Postal Code*
Your Name*
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Email*
Phone*
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Ambulance Insurance HQ helps emergency medical services get the best deal on insurance by connecting them to our network of agencies. When you request a quote from us, we match you with three independent brokers in your state who understand EMS. They compete. You save … more

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843-790-6864