Insurance Binder Request for a Leased Vehicle

The customer listed below has leased a vehicle from our dealership and is required to carry full coverage insurance which includes Liability and Comp/Collision with a maximum of $500 deductible.

Minimum Required Limits:

  • $100,000 per person

  • $100,000 per accident (bodily injury)

  • $100,000 of property damage

VEHICLE INFO:

VIN#:

Instructions for Agent:

ALM Leasing & Rentals LLC dba FlexRide requires the following endorsements to be listed on the Lessee’s policy and to be shown on the insurance binder. If this requirement cannot be met on your part, coverage should be immediately denied.

Loss Payee or Lienholder:

ALM LEASING & RENTALS LLC
25350 PLEASANT VALLEY RD STE 108
CHANTILLY, VA 20152

Additional Insured:

ALM LEASING & RENTALS LLC
25350 PLEASANT VALLEY RD STE 108
CHANTILLY, VA 20152

Please fax or email the accurate binder to:

This form is not the binder and should not be faxed back.

Both endorsements must be visible on the binder.

Please call with any questions: 1-703-910-3593