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Gravity Certs
2025-09-22T20:02:00-07:00
"
*
" indicates required fields
1
Start
2
Business
3
Operations
4
Vehicles
5
Transportation
6
Drivers
7
Finish
Name
This field is for validation purposes and should be left unchanged.
Business Owner's Name
*
First
Last
Contact (Email)
*
Contact (Phone)
*
SMS Consent
By checking this box, you consent to receive text messages from Metro Risk Management Group at the mobile number provided regarding your insurance inquiries, quotes, and policy updates. Consent is not a condition of purchase. Message and data rates may apply. Message frequency varies. Reply HELP for help or STOP to cancel. View our
Privacy Policy
and
Terms of Service
Effective Date for Policy
MM slash DD slash YYYY
Business Information
Legal Business Name
*
DBA
Mailing Address
*
Street Address
City
- Select State -
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Garaging Address
*
Same as Mailing Address
Street Address
City
- Select State -
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Years in Business
*
- Select -
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
FEIN
DOT Number
Federal Filings Required?
Y
N
State Filings Required?
Y
N
Previous Insurance Cancelled or Non-Renewed
Y
N
List all filings required
Is this a new Venture?
*
Y
N
Have you ever driven for or been associated with any transportation operation before?
*
Y
N
Radius of Operations
Total percent of all 4 radius options below must add up to 100%.
Percent 0-50 Miles
*
0
10
20
30
40
50
60
70
80
90
100
Percent 51-200 Miles
*
0
10
20
30
40
50
60
70
80
90
100
Percent 201-500 Miles
*
0
10
20
30
40
50
60
70
80
90
100
Percent 500+ Miles
*
0
10
20
30
40
50
60
70
80
90
100
Percent Total Radius
Time(s) of Service
Hours of Service
Days of Service
How many shifts per day?
Vehicle(s) Information
This section asks to enter all of your vehicles. You may add each vehicle individually, or alternately, if you already have a schedule of vehicles you may upload that instead.
I would like to
Enter Vehicles Manually
Upload a Schedule of Vehicles
Vehicles List
VIN
Year
Make
Model
Value
Add
Remove
Upload List of Vehicles
Please ensure your schedule includes VIN, Year, Make, Model, and Value for each vehicle.
Drop files here or
Select files
Max. file size: 20 MB, Max. files: 3.
Total Number of Vehicles
Do drivers take vehicles home?
Y
N
Are the vehicles solely owned by the applicant?
Y
N
Transportation of Items
Please indicate the extent to which you transport the following as a percentage of total mileage. (Skip if not applicable)
Service Type
% Non-Emergency
% ADA Paratransit
% Emergency
% Special Needs
% Other
Service Provided
% Curb to Curb
% Door to Door
% Door Through Door
% Hand to Hand
Service Arrangements
% Pre-Scheduled
% On-Demand
% Fixed Route
% Deviated Route
Type of Transit
% Wheelchair
% Stretcher
% Ambulatory
Driver Information
Please make sure to include yourself if you are a driver.
I would like to
Enter Drivers Manually
Upload a Schedule of Drivers
Drivers List
If you are a driver, remember include yourself. Date of Birth format must be MM/DD/YYYY.
First Name
Last Name
License Number
License State
Date of Birth
Hire Date
Years Experience
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Add
Remove
Upload List of Drivers
Please ensure your driver schedule includes First & Last name, Date of Birth, Drivers License Number & State, Hire Date, and Years Experience for each person.
Drop files here or
Select files
Max. file size: 20 MB, Max. files: 3.
Total Number of Drivers
# over 70 years old
# under 25 years old
Are drivers considered independent?
Y
N
How often are current MVRs pulled?
Additional Comments
How were you referred to us?
All the above information is accurate and true to the best of my knowledge.
*
Yes
Consent
*
Like most insurance agencies, we use information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance. New or updated information may be used to calculate your renewal premium.
I Agree
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