This is document support for approximate net worth. Files accepted are pdf, jpg, png, doc, docx, xls and .xlsx. You can send up to 3 documents.
If coverage is purchased, you agree to have your attorney furnish quarterly reviews of all quarterly claims that are six months or older and which occurred under the current policy or under previous policies if insured through the same company.
Paratransit requires MVR's be ordered every year. However, every 6 months is preferable.
Liability Limits & UNinsured/UNDERinsured Motorist Coverage
I wish a quote as follows:
Quote off-duty coverage for lessee or driver-owner. (Maximum limit is $100, 000)
- In order to be considered for quotation, you must include the following with this application:
- Financial Statement
- List of all owned or all operated units to include year, make, VIN or I.D. number. (AU units with seating capacity of over 5 seats must be identified and the number of seats given.)
- List any units to be excluded from this quotation.
- Drivers List and Current MVR's.
- Loss Run for prior 3 years.
Accepted file types: jpg, png, pdf, doc, docx, xls, xlsx.
Please electronically sign this application.
A copy of this application will be sent to this address.