Cumulative Rate Change from June 2, 2013 June 1, 2014 – Personal Auto Statewide Rate Change: ___% Homeowners Statewide Rate Change: ___% Condo Statewide Rate Change: ___% Renters Statewide Rate Change: ___% Policy Form Please enter the policy form most likely to be sold to customers; for example, HO-A, HO-2: Auto: _______ Homeowners: _______ Condo: _______ Renters: _______ Discounts, Surcharges, and Other Factors Included in Personal Auto Sample Rate Calculations If the personal auto sample rate includes discounts, surcharges or other factors specific to the particular make, model, and year of the vehicle, please indicate them in the space provided: Personal Auto Insurance Discounts Check the box to indicate the discounts offered: Company name Airbags Daytime Driver’s Claims Driving Low Multiple Young Good Multiple lights ed record mileage policies driver grades vehicles brakes Please list other discounts offered that are not shown above: Company Name Discount Homeowners Contents Coverage Contents coverage provided by policy used for sample rates is the following percentage of the dwelling amount: ____% Homeowners Deductibles
Cumulative Rate Change from June 2, 2013 – June 1, 2014 Personal Auto Statewide Rate Change: ___% Homeowners Statewide Rate Change: ___% Condo Statewide Rate Change: ___% Renters Statewide Rate Change: ___% Policy Form Please enter the policy form most likely to be sold to customers; for example, HO-A, HO-2: Auto: _______ Homeowners: _______ Condo: _______ Renters: _______ Discounts, Surcharges, and Other Factors Included in Personal Auto Sample Rate Calculations If the personal auto sample rate includes discounts, surcharges or other factors specific to the particular make, model, and year of the vehicle, please indicate them in the space provided: Personal Auto Insurance Discounts Check the box to indicate the discounts offered: Company name Airbags brakes Daytime lights Driver’s ed Claims Driving record Low mileage Multiple policies Young driver Good grades Multiple vehicles Please list other discounts offered that are not shown above: Company Name Discount Homeowners Contents Coverage Contents coverage provided by policy used for sample rates is the following percentage of the dwelling amount: ____% Homeowners Deductibles
B-0009-14General%20instructions.docx