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.

    Jaimie Warren





    I joined the Personal Lines team as an Account Manager in the summer of 2022, but moved to Commercial Lines in the fall. I am a licensed Property and Casualty Insurance Agent and I am well-versed in insurance software programs like AMS360. With keen attention to details, I am known for my problem-solving, interpersonal skills, and ability to multi-task with poise and professionalism. I started my insurance career in 2008 at Virginia Farm Bureau, then moved to a large financial insurance agency in Newport News, Virginia where I sold a variety of products including auto, home, boat, RV, motorcycle, and commercial lines coverages. A top-producer in the southeast region of Virginia, I am known to provide high-level, timely and professional customer service.


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