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Agent Checklist for Fleet Submissions


									                                    A Member Of The Meadowbrook Insurance Group

                                 Agent Checklist for Fleet Submissions
                                      New and Renewal Business

To provide you with the best possible quote, make sure that you provide the following

  Completed Application

  Completed Fleet Transportation Supplement (attached)

  Current Equipment list in Excel Spreadsheet format, if possible

  Current Driver list in Excel Spreadsheet format, if possible, and MVRs for each, including
   the owner. Also please include date of hire and years experience on like equipment

  Currently valued hard copy loss runs from insurance carriers (other than Interline) for the
   current and three years prior. Please explain any losses over $25,000

  Copy of current and one year prior financial statement. Please include the most recent Year
   End statement available and include both Balance Sheet and P & L, Income Statement. This
   is required for all accounts (new and renewal) with 15 or more power units, if the account
   has hired auto exposure, and/or you are requesting a Gross Receipts reporting quote.

  If sub haul exposure, please include estimate of owned vs. non owned receipts for the
   coming year, list of sub haulers used with copies of Certificates AND AI’s for each (for credit
   to be applied to HA coverage) and copy of sub haul agreements.

  If insured uses Permanent Leasers, please provide copy of full Lease Agreement.

  Copy of operating authority, filings needed

  Written maintenance plan and safety program, if available

  Copy of latest DOT / BIT inspection

  Copy of Schedule B/IFTA showing distribution of mileage by state. Also, please include
   where hauls are to (by city, region)

  Vehicles greater than 20 years old will require a garage inspection if bound.

                  Please provide this information with as much lead time as possible.
                  30-60 days prior to effective date is recommended to allow time for
                  pre-inspection on new business and company approval (if needed).

 12641 E. 166 Street P.O. Box 3190 Cerritos Ca. 90703-3190 (562) 926-5061 Fax (562) 404-4792 CA License No. 0629313

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