Image by Medienstürmer
PRODUCER SUBMISSION REQUIREMENTS

Downloadable Forms:

ACORD 125 & ACORD 137 

 

Complete with list of the following:

Drivers 

Vehicles with VIN #'s

GVWs

Radius 

Description of Operations 

FEIN # and Dates of Hire (drivers/vehicle must be submitted in excel format)

MOTOR VEHICLE REPORT 

must be within 90 days of coverage inception date

5 YEAR HARD COPY LOSS RUNS - valued within 90 days of coverage inception date 

5 YEAR PREMIUM HISTORY 

 

To establish Loss Ratio (include Historical Unit Count)

COPIES OF REGISTRATION 

NARRATIVE ON LOSSES > 50K

TARGET PREMIUM 

COPY OF SAMPLE CONTRACTS (if any)

 

MOST RECENT 2 YEAR FINANCIALS or TAX RETURNS

INVOICES FOR CAMERA'S AND/OR ELECTRONIC DEVICES (ELD) 

 

If hosted by another administrator, we will require feed from insured.  

DashCam Programs are available with our preferred vendor.