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ABOUT YOUR GOLF CART or LSV |
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Year: |
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CCs:
(if known) |
| Make: |
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| Model: |
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| Type of Vehicle: |
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| Usage: |
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(examples: golf
course, offroad, street usage, hauling, etc.) |
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Usage 2: |
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COVERAGE OPTIONS |
| Liability Limits: |
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Uninsured Motorist Limits: |
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Deductibles: |
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| Motorcycle License
(discount): |
Yes
No
If yes, when did you get it?
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Who insures your cars? |
(if yes, with which
company)
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Discount
Groups: |
 |
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Discount
Groups #2: |
 |
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Please tell us if
you have any tickets or accidents, when they were, and the type.
(Last 3 years) |
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