Buy Now Single Shipment Form

Use this form to insure a single shipment with U-PIC

Please LOG IN if you have a web account.

Orders must originate in the United States or Canada.

Contact our office at 1-800-955-4623 or sales@u-pic.com if you have any questions.

View Coverage Rules

View Online Rates

TELL US ABOUT YOURSELF

Company

Name

Address

City

Country

State

Zip

Phone

Fax

Referred by

TELL US ABOUT THE SHIPMENT

Ship date

Commodity

Is this jewelry?

Is this commodity covered? View Coverage Rules

Insurance value

Recipient company

Recipient name

Recipient country

Recipient state

Recipient zip

Reference

CARRIER DETAILS

Tracking number

Carrier

Service

Service limit:	...
Service deductible:	...
Service rate per DVU:	...
Your insurance cost:	...

FINISHING UP

If you would like to create a web account after you submit this order, check the following box. Having a web account will autofill this form with your contact information in the future to make the process quicker.

Create web account?

The insurance value must be more than zero to insure a shipment.

Have Multiple Shipments to Insure?

If you have multiple shipments to insure, our multiple shipment form may be the best option for you.

Enter all your shipments and pay one time