ACORD Forms: How to Complete a Garage and Dealers Section 128Garage and Dealers Section 128
This guide provides the user with basic instructions for completing the
ACORD Garage & Dealers Section. This form has been designed to
handle the basic underwriting needs for automobile service operations
and automobile dealers.
Space is provided to enter driver information for up to eight drivers. For
additional drivers, ACORD 163, Driver Information Schedule, can be
Insurance coverage, "no fault" and uninsured/underinsured motorists
coverages in particular, varies widely from state to state. In addition,
there are numerous state-specific requirements that apply to Garage and
Dealers applications. ACORD 128 cannot address these various unique
specifications. Therefore, state specific forms, ACORD 138, have been
developed to respond to these requirements. Use the ACORD 138 for
your state to provide coverages/limits information, as well as the
required disclosure and other data unique to the state. See the State
Forms section of this Guide for more information.
This form was alsodesigned to be used in conjunction with the
Commercial Insurance Application - Applicant Information Section
(ACORD 125) and the Vehicle Schedule (ACORD 129). Please turn to
the chapters on these forms for specific information on completing
Many states require supplements to all auto applications, to provide
specific coverage explanations or to allow applicants to accept or reject
certain coverages. In some cases, the applicant must be allowed to select
among various options. In others, laws or regulations require disclosure
of information pertinent to auto insurance.
ACORD has provided the necessary supplements in most states. Refer
to the State Forms section of this Guide.
Much of the information for the Identification Section should match the data found within the
Applicant Information Section of ACORD 125. Nevertheless, it is still important to complete it.
Many companies separate the applications by line of business for rating purposes. Not completing
this portion of the application makes it difficult to keep track of the full account.
Month/day/year on which the form is completed.
Agency's name, address and telephone number.
Applicant (First Named Insured)
First Named Insured as it appears on the ACORD 125.
Proposed Eff. Date
Enter the Effective date on which the terms and conditions of the policy will commence.
Proposed Exp. Date
Enter the Expiration date on which the terms and conditions of the policy will terminate
Indicate whether the agency or the company (direct) will bill the insured or other payor for
Indicate the plan to be used to pay the company for the policy. Use the company's specific
designation for the plan where possible (e.g., Prepaid, Annual, Semi-annual, Bi-monthly,
Use this field to indicate the audit term for policies that are subject to periodic audit. If the
audit period is known, enter the code:
A . . . . . . . . . . . . . . . . . . . . . . . . . . . . annual
S . . . . . . . . . . . . . . . . . . . . . . . . . . . . semi-annual
Q . . . . . . . . . . . . . . . . . . . . . . . . . . . . quarterly
M. . . . . . . . . . . . . . . . . . . . . . . . . . . . monthly
O . . . . . . . . . . . . . . . . . . . . . . . . . . . . other
BUSINESS/VEHICLE STORAGE INFORMATION
This section is used to identify the type of insurance necessary for the applicant.
Auto Service Operations or Trailer Sales
Place an "X" in all applicable boxes to identify the type of operations in which the applicant
Indicate if the dealership is franchised, deals in one or more specific lines of cars such as
Ford or GM, or if it is a non-franchised dealer. Indicate the percentage of vehicle style in
relation to total inventory.
Indicate where the applicant's vehicles are stored.
Enter the location number as it relates to the numbers found on the ACORD 25. For each
location, identify where the vehicles are stored.
Vehicles are stored within a building.
Standard Open Lot
The lot is enclosed by walls or fences at least six feet in height, with openings securely
locked when unattended.
Non-Standard Open Lot
The lot is either an open lot or an unroofed space and the building is not securely enclosed
or locked when unattended.
Covered Auto Symbols
Garage or Dealers policies use numeric symbols on the policy declarations to indicate the
type(s) of vehicles for which coverage is in effect. Be sure to place an X in the appropriate
box for each type of coverage. Only those symbols specified for a coverage may be used.
Symbols 21 through 26 provide fleet automatic coverage. Symbol 21 includes Hired and
Non-Owned auto coverage. If symbol 21 is not used and Hired Auto (symbol 28) or Non-Owned
Auto (symbol 29) coverage is desired, those symbols must be checked.
The symbols indicate the automobiles to which each coverage applies. The symbol
"triggers" the coverage. For exact policy definitions of the symbols, please refer to the
company's policy declarations page.
Symbol 21 - Any Auto
Can only be used for Liability insurance and/or Medical Payments insurance. Its use
provides coverage for any auto the insured will have contact with, including owned & non-owned
& hired vehicles. It includes coverage for non-owned autos, no-fault, uninsured
motorists or physical damage insurance. Damage to customers' autos is provided by using
Symbol 30, Garage Keepers Insurance.
Symbol 22 - All Owned Autos
Provides coverage for owned autos only and includes automatic coverage for autos you
newly acquire. This symbol cannot be used to provide liability coverage for dealers, but can
be used to provide liability for non-dealers. It can also be used for dealers and non-dealers to
provide any of the physical damage coverages or uninsured motorist's insurance.
Symbol 23 - Owned Private Passenger Autos Only
Provides coverage for owned private passenger autos only and includes automatic coverage
for private passenger autos you newly acquire. It can be used for dealers and non-dealers to
provide uninsured motorist's insurance and physical damage coverages. It may also be used
to provide medical payments insurance for non-dealers.
Symbol 24 - Owned Autos Other Than Private Passenger
Provides coverage for owned autos other than private passenger autos and includes
automatic coverage for autos you newly acquire, other than private passenger autos. It is not
limited to trucks or truck tractors, but also includes taxis, motorcycles, emergency vehicles,
trailers and buses. Any vehicle which is not a private passenger auto fits within this symbol.
Symbol 25 - Owned Autos Subject to No-Fault Laws
Applies to owned autos where no-fault is required by law including automatic coverage for
autos you newly acquire.
Symbol 26 - Owned Autos Subject to Uninsured Motorist Laws
Applies to owned autos where there is a compulsory uninsured motorist's law including
automatic coverage for autos you newly acquire where rejection of UM is not permitted by
Symbol 27 - Specifically Described Autos
Provides coverage for scheduled autos only with no automatic coverage for autos you newly
acquire. Use Vehicle Schedule, ACORD 129, to provide information on individual
Symbol 28 - Hired Autos Only
Provides coverage only for autos leased, hired, rented or borrowed by the named insured.
This does not include autos owned by employees or members of their families.
Symbol 29 - Non-Owned Autos Used in Garage Business
Provides liability coverage for autos not owned by the named insured but used in
connection with the garage business. This includes autos owned by employees.
Symbol 30 - Autos Left for Service/Repairs/Storage
Provides coverage for customer's autos which are in the care, custody, and control of the
named insured. It provides garage keepers insurance for dealers and non-dealers when autos
are left for service, repair or storage.
Symbol 31 - Autos On Consignment and Dealer Autos
Provides physical damage coverages for autos consigned to dealer or held for sale in
possession of non-dealer.
Symbol 32 - Company Use
This is a company specific code. It can be used to provide coverage when no other symbol
applies (e.g., to provide coverage for Long Term Leased Vehicles). It will be necessary to
write in this symbol if used.
Coverages & Limits - Use ACORD 138
AUTO DEALERS OPERATORS
The Insurance Services Office developed the Dealers Class Plan to rate liability and collision
coverages. The basis for rating involves assigning rating factors and rating units for employees and
Record by location the number of persons within each category. If rating the policy, refer to the
Commercial Lines Manual for additional information.
DEALERS PHYSICAL DAMAGE
Indicate if the autos to be covered are New or Used for each coverage and check the interest to be
SERVICE OR REPAIR SHOPS
Indicate Annual Gross Sales and the number of gallons of gasoline pumped per year.
NON-DEALERS PREMISES & OPERATIONS
Payroll is the basis for rating this coverage. Enter the location number as it appears on the ACORD
125, the estimated annual remuneration and number of employees at each location. See the
appropriate manual for the payroll limitations that apply.
This section is used to collect information on all the drivers that will be covered under this
account. The driver list should include any family member who will be driving company vehicles
and employees who regularly drive their own vehicles for company business.
Enter the driver's full name. If the company requires the address, enter it as well.
Enter F for female, M for male.
Enter the marital status for each driver. Examples:
S . . . . . . . . . . . . . . . . . . . . . . . . . . . . Single
M. . . . . . . . . . . . . . . . . . . . . . . . . . . . Married
D . . . . . . . . . . . . . . . . . . . . . . . . . . . . Divorced
SP . . . . . . . . . . . . . . . . . . . . . . . . . . . Separated
W. . . . . . . . . . . . . . . . . . . . . . . . . . . . Widowed
Date of Birth
Enter the driver's birth date.
Enter the number of years of driving experience for each driver.
Enter the year in which the driver was first licensed.
Driver's License Number/Soc. Sec. #
Enter the complete driver's license number. If a license number is unavailable, enter the
driver's social security number.
Enter the state in which the license was issued.
Enter the date of hire for each driver.
Use Vehicle and %
Enter the vehicle number that this driver primarily uses and the percentage of driving done
by this driver in this vehicle.
Use the Remarks section to provide additional information for any questions answered with a "Yes"
response. The overview below lists the expected information that should be added to the remarks
section for "Yes" responses.
1. Does applicant rent, lease or loan vehicles to others?
List the frequency, who receives the vehicles and if this is part of the normal business
operations. Indicate if insurance is provided.
2. Does applicant pick-up or deliver customer's cars?
Indicate how many cars per day, and how the employee commutes to the location.
3. Does pick-up or delivery exceed 50 miles?
Indicate the radius of this operation if it exceeds 50 miles, and how often.
4. Is tire recapping or retreading performed?
List the percentage of gross sales this operation represents. Indicate if the applicant sends
out for retreads, or if the applicant performs the operation.
5. Does applicant own or sponsor a car for racing?
Provide a description of the car. Indicate how frequently the car is raced, who drives the car
and how the car is transported.
6. Does applicant handle butane, propane or other gases?
State what type of storage facilities are used, what gases are involved and if they are for sale
to the general public.
7. Are any vehicles furnished for groups or organizations?
Identify the group (school, hospital, church, or civic organization) to which the vehicle is
loaned. Indicate if there is a charge.
8. Does applicant perform spray painting or welding?
Indicate how frequently this type of operation is performed, and if the applicant has
approved booths or ventilated spray areas. Describe the type of welding or painting job
handled and where in the building each job is located.
9. Does applicant drive away or haul away vehicles from factory distributing
point or other dealers?
Describe circumstances causing drive-aways. Indicate if this is a regular operation, how
many cars are involved, and give the radius of operation.
10. Does applicant dismantle autos or have salvage operation?
Describe this type of operation completely. If there is a salvage operation on premises, so
11. Does applicant use tow trucks?
Indicate how many trucks are owned or used by the applicant and describe towing
operations. These trucks may be listed on ACORD 129 Vehicle Schedule and attached to
the Garage Section.
12. Do employees regularly use their own autos on company business?
List who, what vehicle and for what operations.
13. Does applicant park customers' vehicles on public streets or off
Describe any type of off-premises parking of vehicles.
14. Is a charge made for parking?
Indicate how much is charged, how many attendants are on duty, and the hours of
operation. Indicate if employees drive vehicles or if customers self-park.
15. Any private protection systems?
Describe all such systems in detail.
16. Is applicant involved in any "non-garage" operations?
If a retail operation, mini-mart, liquor store, or other operation is run on the premises, list
the operation and annual gross sales from this portion of the business. Indicate if there is
any insurance for this operation.
17. Does applicant perform any road emergency services?
Indicate if the applicant is on call for any highway or other emergencies, and if towing
operations are available around the clock.
18. Any drivers with convictions for moving traffic violations?
Give driver name and number, date, type and place for each conviction. Enter the number
of years reviewed, in accordance with the company's and state's requirements.
Use this section to collect information on any additional interest or receiver of Certificates of
Check all appropriate boxes that apply to the additional interest. If the interest is other
than the listed options, check the last box and list the interest type after it.
Name and Address
List the additional interest's name and mailing address.
Interest in Item
Use this section to indicate what the additional interest has an interest in. Examples:
For a Mortgagee, list the location and building number.
For an automobile lienholder, list the vehicle number.
If the additional interest has an interest in multiple items, such as a lienholder on multiple
vehicles, list all of the numbers associated with the additional interest.
If a Certificate of Insurance is required, check this box.
List any reference number, such as a loan number, that may be beneficial in tying the
additional interest to item.
Use this section to provide any additional information required for underwriting or rating.
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