Car Insurance – Personal Auto Policy (PAP)

An insurance policy that covers incidents involving your car.  The most common coverages are basic liability coverage that pays other people's expenses for accidents caused by drivers covered under your policy; and collision and comprehensive coverage which covers the cost of repairing or replacing your car after an accident, cost of replacing or repairing your car if it is stolen or damaged by fire, vandalism, hail, or another cause other than collision.

Under California Law the minimum amount of financial responsibility required is:

 

$15,000 for bodily injury to one person

$30,000 for bodily injury to all persons

$5,000 for property damage

 

Vehicles not customarily covered by the PAP include:

Vehicles rented to others

Vehicles used to carry passengers for a fee

Motorcycles and other vehicles with fewer that four wheels

General Information:

 
1.  *First Name:  
2.  *Last Name:  
3.  *Phone:  
4.  *Email:  
5.  Address:  
6.  Address:  
7.  City:  
8.  *State:  
9.  *Zip Code:  
9.  County:  
The following questions concern the type of business insurance coverage you are requesting . Please answer them as accurately as possible.
1) Description of the business:
2) What type of entity is your company?
3) Please indicate the state in which your business is located:
4) What is the date of incorporation?
5) Please indicate your total number of full-time employees:
(If Sole Proprietor enter 1)
6) Please indicate your total number of part-time employees:
(If none please enter 0)
7) Please indicate your total annual revenue:
8) Do you currently have business auto insurance? Yes No
9) If you are currently insured, please select your current insurance carrier:
10) If your provider is not listed above, please provide the company name here:
11) How many years have you had coverage with this company?
12) How many years have you had continuous coverage (With no lapse)?
13) If you do not have coverage please indicate when you would like a policy to go into effect:
14) Please indicate the number of automobiles you would like to insure:
Now, take a moment to tell us about the primary vehicles you wish to insure. Please list all other vehicles and their descriptions in the the other vehicles field.
Automobile Information
15) Year:
16) Make:
17) Model:
18) Type:
19) VIN:
20) If commercial, please enter GVW:
21) Number of Doors:
22) Fuel?
23) Cylinders?
24) Turbo/Supercharged? Yes No
25) 4-Wheel Drive? Yes No
26) Anti-Lock Brakes(ABS)? Yes No
27) Alarm Type?:
28) Number of Air Bags?:
29) Seat Belts?
30) Parking:
31) Annual Miles:
32) If new car, what is the MSRP:
33) Leased: Lease Own
Principle place the vehicle will be garaged:
34) Street:
35) City:
36) State:
37) Zip:
38) Best Time To Contact:
39) Additional Vehicles:
Please provide any additional vehicles you would like us to take into account.

 
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