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Secure Transport Application
A- Secure Transport Application
Do you deliver or transport cannabis living plants or harvested goods?
Do you deliver to businesses?
Do you deliver to consumers?
Are any vehicles used to haul steel?
Do any vehicles require a hazardous materials placecard?
Involved in the daily operation of the business?
Is this person required to be a driver?
Drivers License Number:
How many vehicles does the business own?
Are annual motor vehicle reports of all drivers ordered?
Do you allow firearms or weapons in the vehicle?
Garaging Zip Code:
Radius One Way:
100 miles intrastate (within MI only)
100 miles interstate (goes outside MI)
200 miles intrastate (within MI only)
200 miles interstate (goes outside MI)
300 miles intrastate (within MI only)
300 miles interstate (goes outside MI)
500 miles intrastate (within MI only)
500 miles interstate (goes outside MI)
Is vehicle used for:
Is the vehicle used to haul goods on a For-Hire basis?
Does this vehicle need comprehensive or collision coverage?
What is the total value of all permanently attached equipment (including aftermarket parts, mounted equipment, GPS systems, security systems and modificiations)?
More than $2,000
Permanently Attached Equipment Value :
(Enter the total replacement cost for all permanently attached equipment. Permanently attached equipment means equipment and devices that are permanently installed or attached to your insured auto. Permanently attached equipment also includes)
Current Vehicle Value:
(The current retail value of the vehicle excluding any permanently attached equipment. The easiest way to establish a current vehicle value is to consult a blue book publication. Other possibilities include consulting with a dealer/manufacturer or checking internet sites)
Will there be a lienholder on the vehicle?
Number of Drivers:
Date of Birth
Is this driver excluded?
Commercial Driver’s License (CDL) :
(Drivers who have successfully completed knowledge and skill tests regarding the safe operation of commercial vehicles are issued a Commercial Driver’s License or CDL)
Is an SR 22 Required?
List all accidents
(Both at fault and not at fault and violations for the last 35 months, with description of accident or violation and approximate date)
Does the business currently have an auto insurance policy?
Current Policy Number:
Current Policy Effective Date:
Current Policy Expiration Date:
Current Liability Limits:
Has insured had continuous coverage for at least one year?
Year current business was established:
BI-PD Liability Limits:
Covered under Work Comp (All drivers are covered under a worker’s comp policy (only eligible if ALL vehicles have NO PERSONAL USE)
$30 per day
$40 per day
$50 per day
I warrant the above to be true and understand the insurance contract will be considered based on my warranty.
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