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Number of operators
Name, d.o.b., ss# and drivers license for each operator
Number of violations in the last five years
Current auto liability limits (most policies required 250/500 minimum uderlying liablity)
25/50
50/100
100/300
250/500
500/500
25/50
50/100
100/300
250/500
500/500
Current property liability limts (most policies required 300,000 minimum underlying liability)
100,000
300,000
500,000
1,000,000
100,000
300,000
500,000
1,000,000
Additional exposures (list all that apply and the number of them)
Number of cars
Number of motor homes
Number of misc. vehicles
Number of motorcycles
Number of additional residences
Number of owned watercraft
Number of recreational vehicles
Number of rental property's
Any vacant land
Excess Liability Limit
1 million
2 million
3 million
4 million
5 million
6+ million
1 million
2 million
3 million
4 million
5 million
6+ million