New Vehicle Description
Liability / Uninsured Motorists / Medical
Payments
Please note that all
Liability, Uninsured Motorist, and Medical payments must
be the same for all vehicles.
Is this a leased vehicle?
If yes what limits of
liability are required?
Liability Limit - Bodily Injury
Liability Limit - Property Damage
Physical Damage Coverage & Deductibles
Please list the Maximum
Deductibles your company allows.
|
Vehicle |
Comprehensive
Deductible |
Collision
Deductible |
Towing |
Rental |
| 1. |
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**Please
note: that if you do not receive requested information from our office
within a reasonable amount of time. You may need to contact us as soon
as possible to be sure that the information we have is correct.
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Consent
to electronic transmission of information: Use
of the Internet to access Insurance Information involves
the electronic transmission of personal financial
information. When you use the Ricketson Insurance
Web Site you are consenting to electronic transmission
of the information you have requested. Your
consent is effective during the entire time you are
using the Ricketson Insurance Web Site.
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