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Get Northland Insurance N-2379 2003

N Attach Samples of Agreements. LEASED OR HIRED Does Applicant/Insured do trip leasing to the extent that it comprises more than 5% of his gross receipts? If Yes, explain operation in detail: Is equipment leased or hired? With Driver Yes Without Driver No Avg. Duration of a Trip Lease Yes No Attach explanation and examples of agreements. With Hold Harmless Est. Trip Avg. # of Ins. Provided By Naming Other Part Lease Payments Trip Lease As Additional Insured? Per Year Per Year Lessor Less.

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