M5551-FL0213.doc 2026

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The document is a truck insurance application form from Shelly, Middlebrooks & O'Leary, Inc., intended for clients seeking coverage from various insurance companies. It collects detailed information about the applicant's business operations, vehicle details, driver information, loss experience, and desired coverage options. The form includes sections for liability coverage, physical damage coverage, cargo information, and additional endorsements. It also outlines the requirements for uninsured motorist coverage and personal injury protection options in Florida.

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Click ‘Get Form’ to open M5551-FL0213.doc in the editor.
Begin by filling out the 'Policy Term' section, indicating the start and end dates of your insurance coverage.
In the 'Name (and dba)' field, select your business structure from the options provided: Individual/Proprietorship, Partnership, Corporation, or Other.
Complete the 'Mailing address' and 'Premises address' sections with accurate information for correspondence and operations.
Provide details about your business operations in the 'DESCRIPTION OF OPERATIONS' section, including years of experience and whether it is a new venture.
Fill out the 'LIABILITY COVERAGE' section by indicating desired coverage limits for bodily injury and property damage.
For driver information, list each driver's name, license number, date of birth, and driving experience as required in the respective fields.
Review all entries for accuracy before submitting. Use our platform's features to save your progress or share it with others for review.

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Versions	Form popularity	Fillable & printable
2013	4.6 Satisfied (58 Votes)
2010	4.8 Satisfied (57 Votes)

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