[Insured legal name]
USDOT # [USDOT #]
LOSS RUNS REQUEST
TO: CONTINENTAL DIVIDE INSURANCE COMPANY
Email: customercare@bhhc.com
Please forward to me a currently valued record of losses paid/incurred for the following policies:
Policy Number(s): [POLICY NUMBER REQUIRED]
I would like this information for the policy years 2021-2026. Please show the losses by policy and by year, including liability, cargo and physical damage. If there were no losses, please confirm "no losses" in writing.
I will need this information as soon as possible. Please let me know if you have any questions.
Please FAX or EMAIL this information to:
EMAIL: [Email]
I am an authorized representative of the named insured and authorize Continental Divide Insurance Company to release this information to the contacts above.
- Signature:
- Print Name:
- [Your name]
- Title:
- Owner
- Date:
- October 9, 2026