Sierra Oak Insurance Services Inc.

Auto Repair Business Questionnaire

Name:
Email:
Business Information:
Business Name:
Type of work performed:
Business entity:
Do you have a guard dog?		Yes No
Any owned autos?		Yes No
How many mechanics?
Losses in last 3 years?
LPG sales?
U-haul rentals?		Yes No
Do you loan or rent cars to customers?		Yes No
Auto sales?		Yes No
Split rim/re-caps/re-tread/used tire sales?		Yes No
Towing provided?		Yes No
AAA, ASE, or Gold Class I-Car, certified Shop?		Yes No
Your annual gross receipts:
Coverage Information:
Business personal property coverage
Garage keepers coverage
Do you want coverage for defective products and/or faulty work?		Yes No
Excess coverage for employees' tools
Building Information:
Type of construction:
Year building built:
Building SQFT:
Type of business to the left, right and rear:
Last time the plumbing, HVAC, roofing, and electrical was inspected or updated:
Fire sprinklers:		Yes No
Fire alarm:		Yes No Provider:
Burglar alarm:		Yes No Provider:
Do you own the building?		Yes No
If yes, replacement cost: