TRUCK, AUTO, RV, AND MOTORCYCLE DEALERSHIP INSURANCE

1. Named Insured/s

2. Name of Dealership/s

→ If there's any additional (please separate using commas):

3. Quote Need By Date

4. Effective Date

5. FEIN#

→ If there's any additional (please separate using commas):

6. Include full business description of all Named Insureds.

→ If there's any additional info

7. Include full description of ALL non-dealership activities.

8. Complete Employee Census indicating all drivers (demo drivers, DOCs, technicians, parts drivers, valet drivers, etc.) their driver’s license number, state of issuance, date of birth to process Motor Vehicle Records.

9. Uninsured and/or PIP Selection Forms for applicable state signed by Insured. The applicable forms are available on our website.

10. Acord applications completed and signed by Insured and Producer.

11. All supplemental applications completed and signed by Insured and Producer. All of our supplemental applications can be downloaded from our website.

12. Currently valued loss runs to include current year and 3 years prior. Summary recap of losses are needed for garage, garage keepers, property, crime, umbrella and physical damage.

13. Year end Manufacturer’s / Franchise Operating Statement is acceptable in lieu of Audited Financial Statement.

14. Completed Business Income Worksheet. A pre-formatted excel spreadsheet is available on our website.

15. Statement of Values signed by Insured (Blanket and/or Agreed Amount.)

16. Copy of Dealer’s Loaner Agreement.

17. Copy of Dealer’s current Safety Program. Please indicate Insured’s policy on bad driver’s and whether or not employees know Motor Vehicle Record’s will be drawn on them.