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AUTOMOTIVE REPAIR SHOP

Company Name DBA Entity Type
Contact Name Phone Email
Mailing Address City State Zip
Current Ins Company Policy Number Effective Date
Losses in the last four Years Type of Business
Property Coverage
Location 1
Address City State Zip
Construction Type Year Built Square Footage Number of Stories

% Sprinklered

Year Updated Electrical Roofing Plumbing Heating
Building Limit
 Contents Limit
 Date Started at Loc
 # Service Bays
 # Hoists/Lifts/Pits
Francise
 Yes No
Type of Alarm
  
Number of Active Owners Number of Mechanics Number of Clerical
Location 2
Address City State Zip
Construction Type Year Built Square Footage Number of Stories

% Sprinklered

Year Updated Electrical Roofing Plumbing Heating
Building Limit
 Contents Limit
 Date Started at Loc
 # Service Bays
 # Hoists/Lifts/Pits
Francise
 Yes No
Type of Alarm
  
Number of Active Owners Number of Mechanics Number of Clerical
Liability Coverage
Liability Limit

Garage Keepers Liability Limit
Deductible

Med-Pay

Auto Garage Liability Umbrella
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