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Dealers Open Lot Reporting Form

Physical Damage Insurance Program


Reporting Month:
Dealership Name:
Location Address (Include state):
Contact Person:
Contact Phone:
Email:
Fax:

Vehicle Values
New $
Used/Loaners/Service $
Demo $
 
Total Vehicle Values $0.00


PremiumRateTotal Premium
Dealers Open Lot % $0.00
Surplus Lines Tax $0.00
Stamping Fee $0.00
Fire Marshal Tax $0.00
 
Total Due to RJF Agencies: $0.00



This report must be submitted and received by the 10th of the month detailing previous month's inventory values..


"HOW TO CALCULATE YOUR MONTHLY INVENTORY VALUES"

New and used vehicles held for sale:

  • Each vehicle is valued at the amount paid by the dealer (or dealer invoice) for the vehicle either from the manufacturer or by way of trade in from a customer.
  • The inventory value each day is calculated and the value reported will be the sum of each daily value divided by the number of day in the month.

Owned, loaner and demonstrator vehicles:
  • Each vehicle is valued at the purchase price of the vehicle.
  • The total value reported will be the sum of each vehicle owned during the course of the month.
  • Any vehicles bought or sold during the month that they are being reported will be pro-rated for that period they were owned.

You must email or fax a copy of your inventory list with values matching your reported values to:

Laura Stoutenburgh
RJF Agencies, Inc.
Fax: 763-746-8612
Email: stoutenburghl@rjfagencies.com


Please send check payable to:

RJF Agencies, Inc.
Attn: Laura Stoutenburgh
6000 Nathan Lane North, Suite 400
Minneapolis, MN 55442


By submitting this form and typing my name below, I hereby declare that the above reported values are accurate and total my covered automobile inventory applicable to this insurance .

Digital Signature:
Date: 5/17/2008

*Please type the following text in the text box below (case sensitive):



 
RJF Agencies, Inc. | 6000 Nathan Lane North Suite 400 | Minneapolis, MN 55442 | P: 763-746-8000 | Toll Free: 800-444-3033 | F: 763-746-8227