Contractor Automobile Insurance Declaration PDF Details

Contractor declares as follows.

Vehicles: Contractor does not currently own any vehicles.

Coverage: Contractor has obtained, and shall maintain during the term of the Agreement, automobile insurance coverage for “hired autos” and “non-owned autos”.

Hired autos: Coverage is provided only for autos leased, hired, rented, or borrowed for use in the named insured's business.

Non-owned autos: Coverage is provided only for autos not owned, leased, hired, or borrowed by the named insured.

Employees: Coverage includes autos owned by the insured's employees or members of their households, only while used in the named insured's business or personal affairs.

Signer: Authorized Signer Name, Board Position, Signature, Date.

QuestionAnswer
Form NameContractor Automobile Insurance Declaration
Form Length1 page
Fillable?Yes
Fillable fields5
Avg. time to fill out1 min
EditionFY 2020
Matches the agency's fileYes, checked November 3, 2026
Other namesinsurance declaration, auto insurance declaration, automobile insurance declaration
Official sourceDeclaration of Contractor re: Automobile Insurance Coverage, City of San Diego

How to Fill Out Declaration of Contractor re: Automobile Insurance Coverage

Declaration of Contractor re: Automobile Insurance Coverage at a glance

What it is: Declaration of Contractor re: Automobile Insurance Coverage: regarding the Agreement between the City of San Diego, a municipal corporation, and the Contractor.

Who signs: The authorized signer signs on the Signature line.

A filled-in Declaration of Contractor re: Automobile Insurance Coverage example: a contractor with no vehicles signs

Declaration of Contractor re: Automobile Insurance Coverage example filled out, example: a contractor with no vehicles signs
Dana Sample signs the declaration for Sample Courier LLC. The company owns no vehicles, so it declares hired autos and non-owned autos coverage. The picture shows page 1, and none of its entries is real.

How to fill out Declaration of Contractor re: Automobile Insurance Coverage, box by box

Contractor

Declaration of Contractor re: Automobile Insurance Coverage example filled out, contractor

In the blank after "a municipal corporation [City] and", enter the Contractor.

Sign: Authorized Signer Name, Board Position, Signature and Date

Declaration of Contractor re: Automobile Insurance Coverage example filled out, sign: Authorized Signer Name, Board Position, Signature and Date

Under SIGN, fill in Authorized Signer Name, Board Position, Signature and Date.

More rules for Declaration of Contractor re: Automobile Insurance Coverage

Contractor declares as follows: Contractor does not currently own any vehicles.

Contractor has obtained, and shall maintain during the term of the Agreement, automobile insurance coverage for "hired autos" and "non-owned autos".

In the event Contractor subsequently acquires any vehicle(s) during the term of the Agreement, the Contractor shall immediately obtain, and provide to the City the required evidence of, automobile insurance coverage for "any auto," as required in Section 12.4 of the Agreement.

Any Auto: Coverage is provided for any auto, including autos owned by the insured, autos the named insured hires or borrows from others, and other non-owned autos used in the insured's business.

Hired Autos: Coverage is provided only for autos leased, hired, rented, or borrowed for use in the named insured's business.

Non-owned Autos: Coverage is provided only for autos not owned, leased, hired, or borrowed by the named insured. Coverage includes autos owned by the insured's employees or members of their households, but only while used in the named insured's business or personal affairs.

Sources

[1] Declaration of Contractor re: Automobile Insurance Coverage, City of San Diego (the Official source link on this page).

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