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Business Information
Company Name
Name
Email
Submit
General Information
What is your annual costs in Hired Autos?
How many days are vehicles rented each year?
000
What is the total number of Employees traveling for Company using Personal Vehicles?
Does your company have an established policy requiring employees that drive personal vehicles to carry personal auto insurance? Please briefly describe if so.
Do you have any Foreign Auto Exposure? (Rentals or Owned Vehicles)
Do you provide any corporate owned vehicles to officers/owners for use as a personal vehicle?
Submit
Driver Schedule
Officer/Owner Name
Date of Birth
Drivers License #
State of License Issuance
Vehicle Assigned as Personal Vehicle
Column 6
1
1
5
2
2
6
3
3
7
4
4
8
5
6
7
There are no rows in this table
Vehicle Schedule
Year
Make
Model
VIN
Leased/Owned
Leasing Company
Cost New
Garaging Location
State Registered
Gross Weight
Physical Damage Y/N
1
2
3
4
5
6
7
8
9
10
There are no rows in this table
Form Results 2
What is your annual costs in Hired Autos?
How many days are vehicles rented each year?
What is the total number of Employees traveling for Company using Personal Vehicles?
Does your company have an established policy requiring employees that drive personal vehicles to carry personal auto insurance? Please briefly describe if so.
Column 5
Do you have any Foreign Auto Exposure? (Rentals or Owned Vehicles)
Do you provide any corporate owned vehicles to officers/owners for use as a personal vehicle?
1
000
There are no rows in this table
Form Results
Company Name
Name
Email
1
There are no rows in this table
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