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Get in Touch

CONTACT US

Location

37 W Burnside

Bronx, NY 10453

endorsements@ezvbrokerage.com

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TLC Insurance Quote

Insured Name

Email

Phone Number

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DRIVER INFORMATION

Drivers License Number

Submit Picture of Drivers 

License

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TLC License Number

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VEHICLE INFORMATION

TLC Plate Number

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Current Company

Policy Number

Expiration Date

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OPTIONAL 

Vehicle VIN Number

Vehicle Make & Model

Vehicle Year

By using our website, you agree to these terms and conditions.

  1. Services: We provide a form to obtain insurance quotes from various providers.

  2. Accuracy of Information: You are responsible for providing accurate information.

  3. Privacy: We will handle your personal information in accordance with our privacy policy.

  4. Liability: We are not liable for losses, damages, or expenses resulting from your use of our website or any errors.

  5. Indemnification: You agree to indemnify us from any losses resulting from inaccurate information you provide.

  6. Intellectual Property: Our website content is our property and may not be reproduced without permission.

  7. Governing Law: These terms and conditions are governed by the laws of our jurisdiction.

  8. Changes: We may make changes to these terms and conditions at any time.

  9. Contact: Contact us if you have any questions or concerns.

  10. By signing below I, the prospective insured authorize EZ-Vision Brokerage to request by renewal premium and loss runs from my existing carrier, in other words a Change of Broker.

PERSONAL INFORMATION

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