Transcription of AGENCY CUSTOMER ID: BUSINESS AUTO SECTION
{{id}} {{{paragraph}}}
Example: stock market
AGENCY CUSTOMER ID: BUSINESS AUTO SECTION
DATE (MM/DD/YYYY) BUSINESS auto SECTIONBROADENNO-FAULTLIST ALL DRIVERS, INCLUDING FAMILY MEMBERS THAT DRIVE COMPANY VEHICLES, AND EMPLOYEES WHO DRIVE OWN VEHICLES ON COMPANY #NAMESEX* MARSTATDATE OF BIRTHYRSEXPYEARLICDRIVERS LICENSE NUMBER/SOCIAL SECURITY NUMBERSTATELICDATEHIREUSEVEH #%USEDOCCITY, STATE AND ZIP CODEDRIVER INFORMATIONACORD 163 attached for additional driversUSE ACORD 137 FOR YOUR STATE TO PROVIDE COVERAGES / LIMITS INFORMATIONCOVERAGES / LIMITSACORD 127 (2012/03)Attach to ACORD 125 1993-2012 ACORD CORPORATION. All rights ICC (Interstate Commerce Commission), PUC (Public Utility Commission) OR OTHER FILINGS REQUIRED? (If "YES", attach ACORD 194) CAR MODIFIED / SPECIAL EQUIPMENT? (Include customized vans / pickups) $DESCRIPTIONCOST$VEH #VEH #ARE ANY VEHICLES LEASED TO OTHERS? THERE A VEHICLE MAINTENANCE PROGRAM IN OPERATION? OVER 50% OF THE EMPLOYEES USE THEIR AUTOS IN THE BUSINESS ? INFORMATIONEXPLAIN ALL "YES" RESPONSESY / THE EXCEPTION OF ANY ENCUMBRANCES, ARE ANY VEHICLES FOR WHICH INSURANCE IS REQUESTED NOT SOLELY OWNED BY ANDREGISTERED TO THE APPLICANT?
business auto section date (mm/dd/yyyy) broaden no-fault list all drivers, including family members that drive company vehicles, and employees who drive own vehicles on company business.
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: