Van Pools      Class:
NOTE: This worksheet is non-binding and may differ from the actual premium calculated for the policy once the application is submitted. Actual premium can only be calculated following receipt of a properly completed and executed application.
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.
Experience Rating Factor:    

Rates Effective:
Operating Territory



Note: Not all limits are available for all risks - click for more info.

Rating Factors:
BI ILF=
PD ILF =
BI/PD Prim =

Add'l Charges =





 Coverage/Base Rates/Premiums
BI
PD
PPI
PIP
UM
MLPD



Comp OCN Factor =
Comp Age Factor =
Comp Fleet Factor =
Comp Ded Factor =
No Ded Comp Base =
Comp Deduction
$100 Ded Comp Base = 		Comp Manual Page =
Comp Deductible Premium =
Phys Dam Primary Factor =
Comprehensive Premium = 0
  Coll Age Factor =
Coll OCN Factor =
Coll Fleet Factor =
Coll Ded Factor =
$100 Ded Collision Base = 		Collision Manual Page =
Collision Deductible Premium = 0
Phys Dam Primary Factor =
Collision Premium = 0
Physical Damage Premium  0
 0
Minimum Deposit =