AUTOMOBILE

DRIVER INFORMATION

List the names of the applicant’s drivers who maintain a Commercial Drivers License (CDL).

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Are any of the applicant’s officers, partners, or employees furnished an automobile for their personal use? ___ Yes ___ No

Do individuals with an automobile furnished by the applicant purchase automobile insurance on autos they own personally?
___ Yes ___ No

Does the applicant use its own vehicles to tow special equipment such as air compressors or concrete mixers? ___ Yes ___ No

Are any of the applicant’s automobiles used in parades or other events? ___ Yes ___ No

Are any of the applicant’s vehicles laid up and out of service for more than 30 consecutive days or more due to seasonal operations?
___ Yes ___ No

If the applicant uses subcontractors, are procedures in place to monitor receiving certificates of insurance on a timely basis?
___ Yes ___ No ___ No subcontractors

If yes, describe.

Are any of the applicant’s automobiles equipped with cellular telephones, two-way radios, citizens band radios or similar devices? ___ Yes ___ No

How many automobiles are parked at each location overnight?

Does the applicant lease or rent vehicles with operators to others? ___ Yes ___ No

Does the applicant lease or rent vehicles without operators to others? ___ Yes ___ No

Does the applicant travel to Canada or Mexico? ___ Yes ___ No

Do the applicant’s vehicles have theft alarms? ___ Yes ___ No

Do employees take company trucks home? ___ Yes ___ No

If yes, answer the following:

Is the employee allowed to use the applicant's vehicle for personal use? ___ Yes ___ No

Are other family members permitted to use the applicant's vehicle? ___ Yes ___ No

Explain when an employee may take a truck home.

Does the applicant's equipment exceed the standard width and require “oversize” designation? ___ Yes ___ No

If yes, describe the precautions taken to prevent damage to others.

Are drivers trained in cleanup procedures? ___ Yes ___ No

AUTOMOBILE – HIRED AND NONOWNERSHIP

HIRED/BORROWED AUTO

Is the applicant required to provide primary coverage for any hired or borrowed vehicles?
___ Yes ___ No

If yes, answer the following:

Will the applicant hire or borrow the same vehicle for more than six months? ___ Yes ___ No

Note: If yes, the auto should be covered in the same way as an owned vehicle is covered.

Does an employee of the applicant own the vehicle? ___ Yes ___ No

Does the applicant’s employee hire the vehicle in his or her own name to perform the applicant’s business?
___ Yes ___ No

AUTOMOBILE

List all exclusions attached to the personal automobile policy(ies).

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List or describe any special amendments to the personal automobile policy(ies).

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How many vehicles does the applicant own or lease in the following categories?

Identify the number of operators in each of the following categories.

Describe other:

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RECREATIONAL VEHICLES

List all exclusions attached to the policy(ies).

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List or describe any special amendments to the policy(ies).

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How many vehicles does the applicant own or lease in the following categories?

Describe other:

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Identify the number of operators in each of the following categories.

Describe other:

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