Agent Submission

Submit your client's auto glass claim information directly to Gerber Collision & Glass.

Agent Submission Form

Customer Name:

Email (if you have one):

Policy #:

Deductible:

Best Telephone Number:

Agency:

Referring Representative:

Agency Phone:

Vehicle Identification Number (VIN):

Year, Make & Model:

Glass needed:

Notes:

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We proudly stand behind our repair work for as long as you own your vehicle. Learn more about our Lifetime Guarantee.