ATM Quote Form

General Information

First Name *

Last Name *

Title *

Company Name *

Address *

City *

State *

Zip Code *

Phone *

Fax

Email Address *

How many ATM's does your company have in operation? *

We are seeking an insurance quote for... *

Preferred method of contact:

This is not an “Application” for insurance. We ask that you provide general quote request information on this online form for the purposes of gathering general information on your interest in our insurance products and services. A Marshall & Sterling representative will be in contact with you shortly to discuss the formal application process.