Submit Garage Services Risk

Agent Information

Agent Name

Agency Name

Email

Phone

Insured Information

Insured Name

DBA (if applicable)

Contact Name

Contact Email

Contact Phone

Business Website

Years in Business

FEIN/Tax ID

Mailing Address

City

State

ZIP Code

Business Information

Type of Garage Business

Annual Revenue ($)

Number of Employees

Number of Mechanics

Hours of Operation

Average Number of Customer Vehicles on Premises

Property Information

Property Address

Square Footage

Year Built

Construction Type

Number of Service Bays

Sprinklered

Alarm System

Security Features

Operations Information

Types of Vehicles Serviced (check all that apply)

Private Passenger

Light Trucks

Medium Trucks

Heavy Trucks

Exotic/High Value

Other

If Other, please specify:

Coverage Information

Requested Effective Date

Expiration Date

Garage Liability Limit

Garagekeepers Limit

Building Value ($)

Contents Value ($)

Business Income ($)

Tools & Equipment Value ($)

Document Upload

Upload Loss Runs

Drag and drop your loss runs here or click to browse

Upload ACORD Forms

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Upload Property Photos

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