• Commercial Auto Questionnaire

    • Copies of your vehicle registrations will eventually be needed
    • Over five vehicles on the policy we will need loss runs.
    • All vehicles will be rated on Symbol 7 (only autos and trailers listed on policy have coverage)
    • If you need another symbol please advise and we can review with our underwriting team
    • Please provide a copy of your current policy that shows your limits if available.

  • Vehicle registration info and copy of current policy can be securely uploaded at:

    https://responsiveinsurance.com/request-a-proposal/

    If you don’t have this information currently, that’s ok. Complete the questions below and submit this information to get started.

  • If the business is a corporation or LLC, all vehicles must be tilted to the company name. If they aren't, please stop completing the form and notify us so we can explore alternative options with a different company.

  • Is the business a corporation or LLC?
  • Are all vehicles titled to company/LLC?
  • Do you have current coverage?
  • Any lienholders/leasing companies to add?

  • General Questions:

    How are the vehicles used:
  • Are the vehicles used to pick up property from or deliver to individual households (for example appliance delivery or florist)?
  • Used primarily to carry tools or equipment to job sites toperform contracted work and usually parked at the job site?
  • Are the vehicles generally on the road throughout the day transporting property (such as distributors or delivering property to locations other than individual households)?
  • Are they used in dumping?
  • Do you provide for-hire trucking?
  • Do you provide for-hire transportation of passengers?
  • Do you provide waste/recycling/sand or gravel hauling?
  • Is your radius of travel up to 50 miles?
  • 51 to 200 miles?
  • Over 200 miles?
  • Do over 50% of the employees use their autos in the business?
  • Are any vehicles leased to others?
  • Are ICC,PUC or other fillings, not including California MCP65 required?
  • Do operations involve transporting of hazardous material?
  • Do your employees operate company owned autos after normal business hours?
  • Do you obtain MVR verifications?
  • Do you need physical damage coverage for a trailer?
  • Are owned vehicles used for towing special equipment (air compressors, concrete mixers etc)?
  • Is there a vehicle maintenance program in operation?
  • Does the owner of the business own any other vehicles that are registered to them personally?
  • Are any vehicles customized, altered have special equipment or owned by the prospect but not scheduled on this application?
  • Has any policy or coverage been declined, cancelled, or non-renewed during the prior 3 years?
  • Has the prospect had any losses in the past 4 years?

  • Coverages

  • Do you need hired auto liability (liability coverage for vehicles you lease, hire, rent to use in connection with your business)?
  • Is there a written lease agreement?
  • Does the insured need to be named as additional insured?
  • Do you need non-owned auto liability (vehicles owned by employees and used for company business)?
  • Does the prospect have a driver program in place that includes mandatory driving experience of at least three years, monitoring drivers MVRs and requires certificates of auto insurance coverage with liability limits of at least $300,000 CSL or better?
  • Are certificates of insurance kept on file?
  • Would you like physical damage coverages on your vehicles?
  • Please pick a deductible for Comprehensive (optional coverage that protects vehicle against damage not resulting from collision and theft):
  • If would like collision (damage generally resulting from contact withanother vehicle or stationary object) please pick a deductible:
  • Would you need Drive other car coverage? (Coverage under the endorsement would come into play in the event the individual designated in the endorsement (including his or her resident spouse) is driving a nonowned auto for personal use (for example a company car)

  • I have answered the above indicated questions to the best of my knowledge.

  • Should be Empty: