Language
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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.
Format: (000) 000-0000.
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?
*
What is the total annual payroll for all employees?
*
Are you currently insured?
*
Yes
No
Has the business ever had Garage insurance before?
*
Yes
No
With what carrier?
*
When is/was the expiration date?
*
-
Month
-
Day
Year
Date
How many years of prior coverage do you have?
*
Do you sell cars or service them?
*
Sell cars (car dealership)
Service cars (auto repair/body work)
Both sell and service
What percent of your revenue comes from Sales vs Service?
*
Do you do any towing operations?
*
Yes
No
How are keys secured?
*
Cabinet in office
Inside the Vehicle
Lockbox
Other
Are there any security features (burglar alarm, cameras, etc)
*
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.
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Service & Repair Questions
Which of the following repairs/services do you work on?:
*
Airbags
Driver Assist Technology
Roadside Assistance
Alignment
Engine
Sound/Alarm System
Batteries
Fiberglass
Suspension/Frame
Blade/Cutting Equip/Chippers
Frame Straightening
Tires
Body work
Lift Kits
Trailer Hitches
Muffler
Transmission
Oil & Lube
Tune Up
Brakes
Paint
Wash/Detail
Breathalyzers
Performance Enhancement
Welding Operations
Custom/Fabrication
Radiator
Other
What type of vehicles do you work on?
*
Private Passenger Autos
Motorcycles
RV’s / Motorhomes
Heavy Trucks
Semi-Trailers
Buses
ATV’s, Jet Ski’s, etc.
Antique or classic cars
Other
Do you offer mobile repair services?
*
Yes
No
On average, how many vehicles do you have in your garage at one time?
*
What is the average value per vehicle?
*
What is the maximum value per vehicle?
*
Do you drive customers’ vehicles for the purpose of pick up and/or delivery?
*
Yes
No
Do you loan or rent vehicles to customers?
*
Yes
No
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Dealer Questions
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
On average, what is total value of all the vehicles for sale on your lot?
*
On average, what is the maximum value per vehicle?
*
How many dealer plates do you have?
*
Do you have any Transporter or Repairer Plates?
*
Yes
No
Who drives or transports vehicles to your lot?
*
Do you deliver vehicles to customers after the sale is complete?
*
Yes
No
How many vehicles do you sell per year?
*
Do you sell vehicles with salvage title?
*
Yes
No
Do you do any reposessions?
*
Yes
No
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Please list out all employees (Name, Date of Birth, Drivers License Number and State, and job type)
*
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EZ Auto
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