Instructions: If Experience Rating is applicable, use the Experience Rating Worksheet to determine the rating factor (CANNOT = 0!). Make selections, enter the requested information, and click the LIABILITY and TOTAL PREMIUM buttons.
Effective Date
Jan February 2012 Mar Sun Mon Tue Wed Thu Fri Sat 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 1 2 3 4 5 6 7 8 9 10
Select Risk Registration Plates PPTs	Territory/Garaging Location:  Select 11 12 13 17 18 19 23 24 25 26 28 30 31 32 33 34 35
If you change any item(s), click the button again to recalculate the total premium.

Liability Premiums  Note: Not all limits are available for all risks - more info.
Select Coverages		Base Rates	Premiums	Immediate Coverage? If you change any item(s), click the button again to recalculate the total premium. The total policy premium of   is an estimate.  The estimated premium is subject to change pending verification of any information necessary to underwrite the policy.  Amerisure reserves the right to adjust the estimated premium either prior to or after the issuance of the policy, whenever applicable, in accordance with Facility rules.  The minumum deposit is  .
BI:	BI Limits $20/40 25/50 50/100 100/300 250/500 500/500 500/1,000 1,000/1,000 100,000 CSL 500,000 CSL 750,000 CSL 1,000,000 CSL 5,000,000 CSL		0
PD:	PD Limits $10,000 25,000 50,000 100,000 250,000 500,000 1,000,000 100,000 CSL 500,000 CSL 750,000 CSL 1,000,000 CSL 5,000,000 CSL		0
PIP:	Not Principally Operated By Employees Principally Operated By Employees		0
Additional Charges to PIP (MCCA & MACF):
PPI:	No Options		0
UM:	Unisured Motorist?		0
MLPD:	M.L.P.D. (minitort)?		0