Pedicab Insurance - Nielsen Insurance Agency

Welcome to Nielsen Insurance Agency where we are more than just an insurance company.

Please fill out our contact form and one of we will get back to you as soon as possible! We will email you an application as well!

* Please fax or email the driver agreement, pedicab serial numbers, and loss runs, if available.

We can also be contacted by e-mail, phone, or fax so if you are looking for more information or need help with the application, please contact us today!
*Not available in all states

E-mail Taira
Phone: 800-468-5647
Fax: 503-244-6881

Company/Entity Name:
Owner Name:
Address:
City:
State:	Zip:
Email:
Phone:
Number of Pedicabs:
Please list your pedicab(s) manufacturer:
Requested effective date:
Is there a driver training/safety program in force?:	Yes No
Do you have a routine maintenance program? :	Yes No
Do all operators have a valid US drivers license?:	Yes No
Would you like theft & physical damage coverage for the pedicab(s)?:	Yes No
Have you had any claims/losses in the past 5 years?:	Yes No
Who is your current insurance company?:
What is your current premium?
Comments:
What does eight plus six equal? (Enter the numeral, not the text.) The random math question helps stop SPAMbots from sending us junk email.