Insurance Policy Declaration Page PDF Details

If you are like most people, you have no idea what is on your insurance policy declaration page. You know that it is important, but you don't understand why. Let me give you a little information about this document so that you can be more informed when reviewing it. The declaration page is a summary of your insurance policy. It includes all of the pertinent information about your coverage, such as the amount of coverage for each type of insurance and the deductible for each type. This form also lists the name of the insurer and the insured, as well as the policy number. Be sure to review this form carefully to make sure that you are fully aware of your coverage. If you have any questions, contact your agent for clarification.

You will discover information regarding the type of form you need to submit in the table. It will tell you the length of time you'll need to fill out insurance policy declaration page, what fields you need to fill in, and so forth.

Form NameInsurance Policy Declaration Page
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesfillable blank auto declaration page, car insurance declaration page pdf, insurance declaration page, insurance declaration page template

Form Preview Example



Regarding the Agreement between the City of San Diego, a municipal corporation [City]


, [Contractor]

Contractor declares as follows:

1.Contractor does not currently own any vehicles;

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

3.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 6.a of the Agreement.

For the purpose of this Declaration, automobile insurance coverage for “any auto,” “hired autos,” and “non-owned autos” are defined as follows:

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.


Authorized Signer Name




Approved by

Victoria L. Hamilton, Commission for Arts and Culture

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