Rental Car Request Form - Go Rentals

  • What is your first name?
  • What is your last name?
  • What is your email address?
  • What is your phone number?
  • What is the year, make and model of the car that was damaged?
    YearMakeModel
  • What is the name of the body shop where your car is being repaired?
  • What is the name of your contact at the body shop?
  • What is the phone number for the body shop?
  • What is the address of the body shop?
  • Please enter your claim adjuster's name.
  • What is the claim adjusters phone number?
  • What is the claim adjuster's email address?
  • Please enter your claim number, if known.
  • Please enter the coverage amount you have available for a rental car.
  • Documents and Comments

  • Please use this field to upload any relevant documents.
    Drop files here or
    Max. file size: 128 MB, Max. files: 10.
    • Please enter any additional remarks in the space below.

    Danielle Rice





    In the spring of 2022, Danielle joined Avery as a Senior Commercial Risk Specialist. In her role, Danielle will work with Avery clients to develop comprehensive insurance programs and recommend risk management solutions, security policies, business continuity plans, and recovery measures. Prior to joining Avery Insurance, Danielle’s professional experience includes nearly twenty years as a senior account manager in the insurance industry. Her passion for cultivating strong client relationships coupled with a desire to help clients make informed decisions led her to Avery. Danielle has earned her Accredited Customer Service Representative (ACSR) designation and she is a Commercial Lines Coverage Specialist (CLCS) providing expert knowledge in commercial lines of coverage: general liability, commercial property, workers compensation, and business auto, as well as insurance principles.


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