Excess Auto Supplemental Application.pdf

This is an Excess Auto Supplemental Application that must be completed in addition to ACORD applications. The application consists of 7 sections:
1. Vehicle Schedule: lists types of vehicles (Private Passenger, Light Trucks, Medium Trucks, Heavy Trucks, Extra Heavy Trucks, Tractors).
2. Radius: categorizes vehicle usage by distance (Local, Intermediate, Long Haul).
3. Driver Safety Information: inquires about the insured's safety program, safety meetings, full-time safety director, and driver background checks.
4. Vehicle Safety Information: asks about vehicle maintenance programs, maintenance frequency, and in-house repairs.
5. Personal use of company vehicles: explores company policies on personal vehicle use, written policies, and employee family member usage.
6. MCS90 filing requirement: determines if the applicant needs an MCS90 filing.
7. Transporting others' property: asks if the company transports property belonging to others.
The application also includes a fraud warning notice for applicants from various states, outlining penalties for providing false information. The applicant must acknowledge the accuracy of their responses and agree to notify the insurer of any changes.