Auto Ins. Purl
This Auto PURL is used to collect risk information for the purpose of quoting. Do not give or share with clients, in house use ONLY.
Completed By:
Prior Ins. Policy Info:
Ezlynx Client:
First Applicant:
Second Applicant:
Applicant Address:Â
Policy Coverage:
Vehicles on Policy:
Note:Â Since this travel trailer is pulled by a vehicle then it only needs physical damage coverage (Comp & Collision). The Policy coverage above (Liability and Uninsured Motorist and medical) will already be given by the vehilcle that is being used to tow this trailer.
Collector / Classic Car Questions:
Motorcycle Questions:
Motor Home Questions:
Travel Trailer Questions:
All Terrain Vehicle (ATV) / Snowmobile Questions:
Physical Damage Coverage (Full Coverage):
Note: This will transfer the information from this form (Purl) to the matching CPA to help you shop all the carriers and determine the best options.