Insurance Needs Survey - Dealers

Fields marked with Required field are required

Required field Name:
Required field Company Name:
Address:
City:
State:
Required field Zip Code:
Required field Phone Number: 000-000-0000
Required field What brands do you sell?
Required field Have you stopped selling any brand in the last two years?
Yes No
If so, which ones?
Required field Do you sell all available models within a brand? (i.e. jet skis, ATV, 4 wheelers)
Yes No
Required field Do you repair/warranty service on site?
Yes No
Required field Do you allow test drives for prospective owners?
Yes No
Required field What precautions do you take to assure that a customer is qualified to operate a unit?
Historical
2001 2002 2003 2004
Required field Annual Total Sales: $ $ $ $
Required field Units Sold - New:
Required field Units Sold - Used:
Required field Aftermarket Merchandise: $ $ $ $
Required field Supplies: $ $ $ $
Enter zero (0) if not applicable
Required field Loss Information: Insurance company loss runs from your current agent
General Information
Required field Do you currently have property coverage on your building?
Yes No
Required field Do you currently have products/completed operations insurance?
Yes No
Required field Do you believe your insurance cost is in-line with competitors?
Yes No
Required field Do you believe your insurance carrier prices your coverage...
Fairly Unfairly based on their knowledge of your business?
Required field Have you been restricted or prevented from certain business activities by your insurance carrier?
Yes No
Required field Can you estimate your liability insurance cost per bike sold?
$
Product Demos
Required field Do you demo any of your products?
Yes; How frequently?
No
Required field What controls are in place before allowing a customer to demo?
Required field What products are demonstrated?
Inventory
Required field Do you store any inventory outside?
Yes No
Required field If yes, how much?
Crated: $
Assembled: $
Customers: $
Required field Is it secured in a locked fenced area?
Yes No
Required field Is the fence connected to a central station alarm?
Yes No
Required field Does the service department do any type of welding?
Yes; Provide Details:
No
Required field Do you make any vehicle alterations?
Yes; Explain:
No
Required field Any parts fabriacation?
Yes No
Required field Do you provide any winter/summer storage for customers' motorcycles, ATVs, snowmobiles, pwc, etc.?
Yes No
Required field If yes, how many units?
Required field What is the total value of these units? $
Required field Does the insured do any spray painting?
Yes; Provide details:
No
Required field Do you loan out motorcycles to customers or others?
Yes; How often?
No
Additional Information Needed
  • If the insured carries inventory by multiple manufacturers, list the percentage of receipts by manufacturers.
  • Need the dollar amount of Business Personal Property inventory the insured had by month for the past 12 months. (Include furniture/fixtures, parts/accessories, power products, shop equipment, any property you own)
    Jan $
    Feb $
    Mar $
    Apr $
    May $
    Jun $
    Jul $
    Aug $
    Sep $
    Oct $
    Nov $
    Dec $
  • Complete Owner & Employee List
  • Need hard copy loss runs for the past 4 years
Required field Are you doing normal service work?
Yes No
Required field Any towing?
Yes No
Required field How many years experience does owner or manager have?
Required field Total number of employees?

Neither the NMDA nor its agents will disclose this information to any third party. Other than in the pursuit of an association insurance program to benefit you and other NMDA members, and then only in a compiled format without specifics from your individual survey information.