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Garage + Dealers Insurance
Company Name
*
Legal Entity Type
*
LLC
Partnership
Corporation
Individual/Sole Proprietorship
Business Start Year
EIN
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Owner Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Years of experience in this industry
Estimated Annual Revenue
How many employees do you have?
How much do you pay them per year? (total payroll)
Do you use insured subcontractors and keep copies of COI?
How much do you pay them per year?
Describe your business operations
Are you currently insured?
Yes
No
Who is your current carrier?
When is the expiration date?
-
Month
-
Day
Year
Date
How many years of prior coverage do you have?
Do you do any towing operations?
Yes
No
Do you do any reposessions?
Yes
No
Do you do any auto repair?
Yes
No
Please select the type of coverages you need:
Garage Liability - protects your business from liability if a covered accident happens in the course of business operations.
Garagekeepers - protects your business if you accidentally damage a customer’s vehicle
Dealers Open Lot - provides physical damage coverage for fleets of vehicles owned and held for sale by licensed auto dealerships.
Scheduled Auto - provides liability and/or physical damage coverage for vehicles your business owns.
What is the total value for all the customer vehicles on your premises?
What is the maximum value per vehicle?
What types of customer owned vehicles are on your premises?
Private Passenger Autos
Motorcycles
RV’s / Motorhomes
Heavy Trucks
Semi-Trailers
Buses
ATV’s, Jet Ski’s, etc.
Antique or classic cars
Is the lot enclosed on all sides with a metal fence six feet or more in height?
Yes
No
What is the total value of all the vehicles for sale on your lot?
What is the maximum value per vehicle?
What types of vehicles do you have for sale?
Private Passenger Autos
Motorcycles
RV’s / Motorhomes
Heavy Trucks
Semi-Trailers
Buses
ATV’s, Jet Ski’s, etc.
Antique or classic cars
Is the lot enclosed on all sides with a metal fence six feet or more in height?
Yes
No
What are the VIN numbers for your vehicles? What coverages do you need (liability and/or physical damage)?
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