Automotive Specialty Insurance

Program Application

If you are a manufacturer, distributor or Retailer and would like a quote for Property, Liability (Including Product Liability), Auto and Umbrella coverage, please complete the attached form.

Workers Compensation

To obtain a Workers Compensation quote, please complete the attached application. Note; Mandated restrictions for Ohio, Washington, North Dakota, and Wyoming, insurance provided by the State Fund.

Garage Application

Please complete the attached application if your company works on vehicles as its main souce of revenue.

Business Income Worksheet

The following form may be completed in order to begin evaluating the limit needed should business interruption coverage be desired.

Statement Of Values

The following form can be used to evaluate property coverages and the respective values needed post loss.

EPLI Application

To obtain a no obligation quote for Employment Practices Legal Liability, please complete the attached.

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