J. Van Financial Group, PLLC. - Garage Owners Quote

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Garage Owners Quote

Garage Owners Quote Request

Contact Information

First Name:

Last Name:

Daytime Telephone:

Evening Telephone:

Email:

Address:

City:

State:

Zip:

Years In Business:

Years Sales/Repair Experience:

Business Entity:

Individual

Partnership

Corporation

Describe your Operations:

Locations where you conduct Garage Operations:

Location 1:

Location 2:

Underwritting Information List of Drivers (Owners, Employees, Family)

Name
Drivers License		State of License:
Date of Birth		Furnished Auto: YES NO
Job Description and / or Relation:		Past 3 Years Number of:
		Accidents :
		Citations:

Name
Drivers License		State of License:
Date of Birth		Furnished Auto: YES NO
Job Description and / or Relation:		Past 3 Years Number of:
		Accidents :
		Citations:

Name
Drivers License		State of License:
Date of Birth		Furnished Auto: YES NO
Job Description and / or Relation:		Past 3 Years Number of:
		Accidents :
		Citations:

Name
Drivers License		State of License:
Date of Birth		Furnished Auto: YES NO
Job Description and / or Relation:		Past 3 Years Number of:
		Accidents :
		Citations:

Name
Drivers License		State of License:
Date of Birth		Furnished Auto: YES NO
Job Description and / or Relation:		Past 3 Years Number of:
		Accidents :
		Citations:

Name
Drivers License		State of License:
Date of Birth		Furnished Auto: YES NO
Job Description and / or Relation:		Past 3 Years Number of:
		Accidents :
		Citations:

Sales

Where do you purchase vehicles?

Who drives or tows vehicles to your lot?

How many times per year do you drive-away more than 300 miles from point of purchase?

How many vehicles do you sell per year?

How many of those are on consignment?

What is your normal radius of operation?

What is your sales mix?

a. cars, sport utility, pickups, vans	%	d. trucks, tractors, semi-trailers	%
b. motor homes	%	e. salvage parts	%
c. travel trailers, camp trailers	%	f. other	%

Describe your theft barriers (fence & gate or post & cable)

Describe your key controls

How many dealer plates do you have?

Do you repossess vehicles? YES NO

If yes, explain

Do you sell "salvage titled" vehicles? YES NO

If yes, what percentage of vehicles require:

% cosmetic repair

% mechanical repair

% structural repair

Do you always ride along on test drives? YES NO

Services

What percentage of your work is:

Body/Paint	%	Muffler	%
Tune Up	%	Radiator	%
Transmission	%	Wheel Alignment	%
Brakes	%	Oil & Lube	%
Sound System	%	Window Tint	%
Tires	%	Upholstery	%
Wash/Detail	%	Other	%

Describe:

Do you sell gasoline: YES NO

or LPG: YES NO

If yes, how many gallons:

Do you install trailer hitches? YES NO

Do you have a spray paint booth? YES NO

If yes, is it U/L approved? YES NO

Is it ventilated? YES NO

Do you recap tires or sell recapped tires? YES NO

Do you tow for hire? YES NO

If yes, explain

Describe lot security and key controls

Prior Carrier and Loss History for 3 Years

Current Carrier:

Policy Period:

Policy Premium:

Prior Carrier:

Policy Period:

Policy Premium:

Prior Carrier:

Policy Period:

Policy Premium:

Date of Loss:

Amount:

Description of Loss:

Date of Loss:

Amount:

Description of Loss:

Date of Loss:

Amount:

Description of Loss:

Coverage Requested

Garage Liability	$
Each accident	$
Aggregate, Deductible	$

(Legal Liab.) Garage-keepers	$ per location
SCL	$ deductible
Collision	$ deductible

Dealers Physical Damage	$ per location
SCL	$ deductible
Collision	$ deductible

Type:

New

Used

Interests Covered:

Owner

Owner and Creditor

Consignment Owner

Premises Medical Payments $1,000

Specifically Described Autos:

Veh.No.		Year		Make
Body Type		ACV		V.I.N.

Veh.No.		Year		Make
Body Type		ACV		V.I.N.

Veh.No.		Year		Make
Body Type		ACV		V.I.N.

Veh.No.		GVW		Radius
Use		Loss Payee

Veh.No.		GVW		Radius
Use		Loss Payee

Veh.No.		GVW		Radius
Use		Loss Payee

Uninsured Motorist: $

Personal Injury Protection: $

Fire Legal Liability: $ 50,000

Buy-backs:

GK Transit Limit: $

Drive-Away Miles: $

Value per Auto: $

Remarks:

Comments or Questions:

Deliver quote via:

E-Mail Fax Regular Mail Telephone

No coverage of any kind is bound or implied by submitting information via this online form
We value your privacy. Every precaution has been taken to insure your privacy and security. Our intent is to release information to you only. We will not provide your data to any third party or group for sales, marketing, or any other purposes. By submitting this form, you agree to release us from any liability should this information be accidentally viewed by others.

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