Apply

Welcome to the Dealers Insurance
Welcome to the Dealers Insurance Services quote request system. Our agency is contracted with the top insurance carriers in the industry and whether you are looking for a bond, insurance or both, we should be able to help! We are in the process of expanding the states in which we offer coverage.
Please choose the state you are located in:*
Terms and Conditions

Completion of our online application constitutes permission for Dealers Insurance Services, LLC and their insurance company partners to obtain consumer information that will be used to determine eligibility and pricing of products offered. Depending on the product you are applying for, the information may include a credit inquiry or drivers license check. Any information obtained will be held in the strictest confidence and is not shared with any other parties. *Credit inquiries, when needed, are considered "soft" and should not impact your score. All questions on this application must be answered truthfully. I understand false statements may result in a declination of the quote request. Any person who knowingly, and with the intent to injure, defraud or deceive any insurer by providing false or misleading information is guilty of a felony. Please complete the application to the best of your ability. Each submission is reviewed by a qualified and licensed agent prior to quoting. If there is any information on the application either incomplete or not properly submitted, you will be contacted by someone from our offices for clarification. By clicking next, you are accepting the above terms and conditions. This authorization is to remain in force until rescinded in writing by the applicant.

GENERAL INFORMATION
Business Name (must match the name submitted to the DMV on the dealers license application)
Year Business started
If less than 3 years in business, years experience in the automotive industry
Contact Information
Name*
Email*
Phone*
Mailing Address
Street:*
City*
State*
Zip code*
Location Address
Is location address same as mailing?*
- Yes
- No
Street:
City
State
Zip code
Application Type
Is this application for Insurance or bonds for a Motor Vehicle Dealers License?*
- Yes
- No
Type of license (click all that apply)
- Independent dealer
- Franchise Dealer
- Wholesale Dealer
- Auction
- Salvage Dealer
- New Recreational Vehicle Dealer
- Used Recreational Vehicle Dealer
Briefly describe your business and or what type of coverage you are applying for:
Applying for:*
- Bonds
- Insurance
- Insurance and bonds

You have successfully completed the application for dealer bond. Next, would you like to:*
- Submit and exit the application
- Continue to apply for your insurance

INSURANCE QUOTE INFORMATION
Type of vehicles*
- Private Passenger Autos and Light Duty Trucks
- Medium or Heavy duty trucks
- Motorcycles
- Boats or Jet Skis
- Recreational Vehicles
- Golf Carts or ATVs
- Salvage or rebuilt titles
Do you do repair work for others?
- Yes
- No
Percentage of total sale generated from repair
Check all that apply
- General Service (oil changes and other maintenance type service)
- Mechanical (transmissions, engines, brakes)
- Tires
- Body work or painting
- Other
Other
Current Insurance Carrier
Renewal Date
Any losses (hard copy loss runs from your prior carrier will be required to provide a firm quote)
- Yes
- No
Please provide a brief description of the losses.
COVERAGES REQUESTED
Garage Liability- (Garage liability provides protection for bodily injury and property damage claims to 3rd parties for which your dealership is held liable)
Dealers Physical Damage (Dealers physical damage insures your vehicle inventory for losses caused by collision, theft, vandalism and when available, weather)
- Yes
- No
Total maximum $ amount inventory held for sale- (you must purchase a limit of insurance equal to 100% of your inventory in order to avoid a coinsurance penalty at the time of a loss)
Maximum value any one vehicle
Lot protection
Garage Keepers Liability - (Garage Keepers covers customers vehicles left in your care, custody and control)
- Yes
- No
Total maximum $ amount customers vehicles on premises
Rating information
Tags
Number of Dealer tags
Any motorcycle or transporter tags
- Yes
- No
Any registered tags on vehicles such as tow trucks etc.
- Yes
- No
All employees including owners
Employee I
Full Name
DOB
DL# & State
Job title (check all that apply)
- Owner
- Manager
- Sales
- Mechanic
- Lot/porter
- Clerical
- Other
Furnished a demo for personal use
- Yes
- No
Full time or part time (under 20 hours a week)
- Full Time
- Part Time
Employee II
Full Name
DOB
DL# & State
Job title (check all that apply)
- Owner
- Manager
- Sales
- Mechanic
- Lot/porter
- Clerical
- Other
Furnished a demo for personal use
- Yes
- No
Full time or part time (under 20 hours a week)
- Full Time
- Part Time
Employee III
Full Name
DOB
DL# & State
Job title (check all that apply)
- Owner
- Manager
- Sales
- Mechanic
- Lot/porter
- Clerical
- Other
Furnished a demo for personal use
- Yes
- No
Full time or part time (under 20 hours a week)
- Full Time
- Part Time
Employee IV
Full Name
DOB
DL# & State
Job title (check all that apply)
- Owner
- Manager
- Sales
- Mechanic
- Lot/porter
- Clerical
- Other
Furnished a demo for personal use
- Yes
- No
Full time or part time (under 20 hours a week)
- Full Time
- Part Time
All non-employees furnished a demo for personal use
Non-employees I
Full Name
DOB
DL# & State
Non-employees II
Full Name
DOB
DL# & State
Non-employees III
Full Name
DOB
DL# & State

You have successfully completed the application for insurance. Next, would you like to:*
- Submit and exit the application
- Continue to apply for your bond

Skip to content

Accessibility Tools

Increase Text
Decrease Text
Grayscale
High Contrast
Negative Contrast
Light Background
Links Underline
Readable Font
Reset