Change Request Form

BIG, Inc.

619 Enterprise Dr. STE 202
Oak Brook, IL 60523
U.S.A.

Tel: (630) 570-0074
Fax: (630) 570-0046

Mon-Fri 8:30 a.m. 5:00 p.m.
Sat closed closed
Sun closed closed

Submit a Change Request Form

Bondar Insurnace Group - Change Request Form
(As it appears on your policy)
(Name of the person submitting this form)

Add to:

* A down payment may be required before addition can be made. If policy is financed with a finance company,
the contract must be current for addition to occur.

For many policies, insurance carriers will not allow for you to remove liability and maintain only physical damage
or cargo. This is due to the MCS-90 provision passed by Congress in 1980.

Delete From:

* Termination Letter or Bill of Sale or Police Report indicating Stolen Vehicle

Including:
Drop a file here or click to upload Choose File
Maximum upload size: 16MB

* Termination Letter - Signed by Company and Owner Operator.
For many policies insurance carrier will not allow for you to remove liability and maintain only psychical damage
and cargo. This is due to the 1980 MCS-90 provision passed by Congress.

DRIVER CHANGE

* If MVR is needed, it will delay processing of request. Driver Employment History needed for drivers with less
than 3 years in currently licensed state.


Sending

Call us at (630) 570-0074