Does the Insured Have a Formal Driver Safety Program? Yes No

Automobile Fleet Questionnaire

Named Insured:

Driver Safety:

Does the insured have a formal driver safety program? yes no

Does the insured conduct periodic safety meetings with the drivers? yes no

Is driver training done with new employees? yes no

Is there periodic in-service training for all drivers? yes no

Does the insured utilize self-inspection/vehicle safety checklists? yes no

Is there a safety committee? yes no

Is there a safety manager or designated person in charge of driver safety? yes no

Does the insured conduct a formal review of all accidents? yes no

Driver Selection:

Does the insured check driver records (MVR’s) annually? yes no

If not annually, at what frequency?

Are MVR records checked Pre-employment? yes no

Is there a set of driver guidelines that are enforced with disciplinary action taken for unsatisfactory driving records, serious violations, accidents, etc? yes no

If so, please attach a copy.

Does the insured run background checks on new and existing drivers? yes no

-Criminal Records? yes no

-Previous employers? yes no

-Are references checked? yes no

-What is the annual turnover rate of drivers? %

-What percentage of drivers are employed 10 years or more with the insured? %

-Do any drivers possess CDLs? yes no

If so, what percentage? %

Are medical exams required on all drivers? yes no

-Pre-employment? yes no

-Annually on all drivers? yes no

Is Drug and Alcohol testing done? yes no

Please provide details and frequency.

Driving Policies and Procedures:

Does the insured have a written policy concerning use of vehicles? yes no

Is the policy signed and acknowledged by each employee? yes no

Does the insured have a written policy on Cell Phone use, texting, etc. in vehicles? yes no

Is the policy signed and acknowledged by each employee? yes no

Are any vehicles taken home by employees? yes no

If so please detail.

Is personal use of vehicles allowed? yes no

Family use? yes no

If so, is there a formal personal use policy? yes no

Vehicle Maintenance Program:

Is there a formal scheduled preventive maintenance program? yes no

Is a written maintenance schedule and/or file used for each vehicle? yes no

Does the insured perform vehicle maintenance in-house? yes no

Are major repairs contracted out? yes no

Does the insured have fueling operations on the premises? yes no

What are the training and experience of the insured's mechanics?

Is there a scheduled vehicle replacement program? yes no

Garage and Storage locations:

What is the maximum number of vehicles stored in one building?

What is the maximum number of vehicles stored at one location/storage lot?

Please list the locations of any vehicle storage that exceeds 10 vehiclesand/or exceeds $500,000 in total value per location.

Address:Number of Vehicles: Total Values: $

Are any vehicle storage locations located in FEMA designated Flood zones? yes no

Additional Comments and/or explanation:

Application Completed by (Name & Title)

Signature Date