Reserve the OCI Mobile Marketplace

Please use the form below to request the OCI Mobile Marketplace for your town or city. After you submit the form, we will contact you with more details on availability, etc.

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* Contact Information

Name: *

Agency or Business: *

Address:

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *

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* Please select a date for your Mobile Marketplace event:

Event Date:

Date

Pickup Date:

Date

Dropoff Date:

Date

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* What hours would you like to schedule for your event? (eg. 10:00am to 7:00 pm)

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* Where would you like to take the RV?

Park it outside agency or business

Grocery or other store

Parade

Tailgate

Other Event (please explain)

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* OCI/Carrier Appointments/Marketplace Certification

I verify I am Marketplace certified and appointed through OCI to write policies for BCBSNE, UHC, Coventry of NE, and Medica.

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* How will you be promoting your event?

Newspaper ad

Local flyers around town

Radio ad

Social Media

Linked with enrollment at business

Not Applicable - This is for a private event

Other (please specify)

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* Marketing prior to your event is critical for success. Please describe your marketing plan.

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* Other Notes:

* Please note that we will do our best to schedule you for your desired date and time, but certain days may not be available or we may not be able to guarantee your date if you are unable to pick up/drop off the RV from our office or another location on our route. All RV requests must be approved by OCI management. We will contact you promptly to inform you of availability. Thank you for your understanding.