Garage Liability Quote
If you see the Secured by
Geotrust Icon below the webpage is secure and your transmitted
information is safe!
WE NEED THIS
INFORMATION !
One of the key factors in
obtaining an accurate insurance quote is accurate
information.
If you have a question about
any of the information you need to provide us , .
Your Name
Business Name
Address
Apartment
Number
City
State
New Mexico
California
Colorado
Zip
Phone
E-Mail
Business
Information
Business Description*
Business is an*
Sole Proprietorship
Partnership
Corporation
LLC
Joint Venture
Type of Business*
Office/Professional
Retail
Contractor
Manufacturer
Distributor
Other
Years In Business*
Annual Sales*
Annual Payroll*
Number of Employees*
Operation Specifics
Years In Business*
Years Sales/Repair Experience
What are your normal business
hours?
Are autos stored at
your premises after normal business hours?
No
Yes
If yes, describe your
theft barriers/storage at each location, for autos
you OWN (building fence & gate or post & cable:
Do your own or lease
location?
Own
Lease
Do you have or maintain animals on your premises?
No
Yes
If yes,
what types/breeds?
Are this/these animals pets?
No
Yes
Not Applicable
Are they used for
security purposes?
No
Yes
Not Applicable
Do you test drive customers vehicles?
No
Yes
Please provide a value and number of autos stored
Max value of ALL autos
Avg. value per auto
Max value per auto
Avg. # of autos
Max # of autos
Describe your key controls
Describe your key controls after
business hours:
Do you pick up or
deliver autos not owned by you?
No
Yes
Do you tow for hire?
No
Yes
Who drives or tows
vehicles to your premises?
What is your normal
radius of operations?
Do you
Loan or Lease autos?
No
Yes
If yes, do you loan
or lease autos to
No
Yes
Do you loan or lease
autos for shorter than 12 months?
No
Yes
Do you sell or store
salvaged autos?
No
Yes
Has your Insurance
been canceled or
non-renewed within the last 3 years?
No
Yes
Please provide
your percentage of operations
Private passenger cars,
SUVs, pickup trucks, vans:
Sales
Repair
Motor Homes:
Sales
Repair
Motorcycles:
Sales
Repair
Motor-coaches of buses:
Sales
Repair
Watercraft (boats, jet skis, etc.):
Sales
Repair
Dirt Bikes or ATVs:
Sales
Repair
All other Recreational
Autos:
Sales
Repair
Commercial Vehicles:
Sales
Repair
Equipment (farm, construction, contractors,
etc.):
Sales
Repair
Travel Trailers or Camper Trailers:
Sales
Repair
Utility
Trailers or Livestock Trailers:
Sales
Repair
Trucks, Tractors,
Semi-Trailers:
Sales
Repair
Salvage Title Autos:
Sales
Repair
Salvage parts:
Sales
Repair
Other:
Sales
Repair
Gross Receipts Breakdown
All
Vehicle/Equipment Sales:
All Repair:
Other Product Sales:
Tow Truck
Operations:
Dealers Section
Where do you purchase
vehicles?
Do you buy or sell
vehicles on the internet?
No
Yes
Do you drive away
more than 300 miles from the point of purchase?
No
Yes
How Many Vehicles do you sell per
year?
How many of these are on
consignment?
How many dealer
plates do you have?
Do you repossess
vehicles?
No
Yes
Do you allow Test
Driving of Vehicles?
No
Yes
Do you always obtain
a copy of the customer’s license?
No
Yes
Do you always obtain
proof of insurance?
No
Yes
Do you always ride
along?
No
Yes
Service/Repair/Installation Section
What percentage of your work is..
Oil & Lube
Breaks
Frame work
Clear Coating
Lift Kit
Installation
Tune Up
Hitches
Painting
Stereo System
Suspension (not
lift)
Muffler
Upholstery
Body Work
Alarm System
Wheel Alignment
Radiator
Tires (new)
Wash/Detail
Transmission
Performance
Adjust.
Electrical
Tires (used)
Window Tint
Windshield
Other:
Do you do any
welding?
No
Yes
Do you have a paint
booth?
No
Yes
Do you sell Gasoline
or LPG?
No
Yes
Do you recap tires or
sell recapped tires?
No
Yes
Employee/Owner
Information *This
information is required by some Garage and all Dealer
companies.
Employee/Owner Name
Date of Birth
Drivers License #
DL State
Title
Job Duties
Driver?
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
Coverage Requested
Garage
Keepers with Liability Only
Garage
Keepers with Comprehensive & Collision
Dealers
Physical Damage with Liability Only
Dealers
Physical Damage with Comprehensive & Collision
Premises Medical Payments
Uninsured Motorist
Fire
Legal Liability
