If you are already a Lancer Commercial Auto & Garage producer, please submit business using our Agency Headquarters online quoting portal. If your office has not yet been trained on the use of Agency Headquarters or if you are a prospect producer, please complete and email the appropriate application below. 

Commercial Automobile Application (NY & NJ) — For Business Auto, Truckers or Tow Truck applicants
Word Document     Adobe.pdf

Commercial Automobile Application (PA) — For Business Auto, Truckers or Tow Truck applicants 
Word Document    Adobe.pdf

Commercial Automobile Application (CT) — For Business Auto, Truckers or Tow Truck applicants 
Word Document     Adobe.pdf

Supplemental Automobile Schedule (NY & NJ) — For Business Auto, Truckers or Tow Truck applicants if Schedule of Autos has 5 units or more 
Word Document     Adobe.pdf

Garage Liability Application (NY & NJ; Dealers - NY only)* — For Garage Dealer and Non-Dealer applicants (service stations, auto repair shops, used car dealers, gas stations with convenience stores, parking garages, etc.) 
Word Document     Adobe.pdf

Garage Liability Non-Dealer Application (CT & NY) — For Garage Non-Dealer applicants (service stations, auto repair shops, body & fender, parking garages, towing services, etc.)
Word Document     Adobe.pdf

Convenience Store Liability Supplement Application (NY & NJ)* — For Non-Dealer applicants with a convenience store exposure (written in conjunction with Garage Liability policies) 
Word Document     Adobe.pdf

Dealer & Transporter Plate Application (NY) — For Dealer and Transporter Plate Liability if applicant requires Transporter Plates only or operates from a non-commercial location  
Word Document     Adobe.pdf

Dealer & Transporter Plate Application (Other than NY) — For Dealer, Transporter and Repairer Plate Liability if applicant requires Plates only coverage or operates from a non-commercial location
Word Document     Adobe.pdf

Hired Car Application (NY & NJ) — For Business Auto and Trucking applicants requiring State or Federal Motor Carrier Filings (written in conjunction with Lancer Commercial Automobile policies) 
Word Document     Adobe.pdf

Non-Ownership Application (NY & NJ) — For Business Auto and Trucking applicants requiring Auto Non-Ownership Liability (written in conjunction with Lancer Commercial Automobile policies) 
Word Document     Adobe.pdf

Garagekeepers Legal Liability & Dealers Open Lot Application (NY & NJ)* — For Garagekeepers Legal Liability applicants (service stations, auto repair shops, parking lots, parking garages, etc.) and for Dealers Open Lot (Physical Damage) applicants (used car dealers) 
Word Document     Adobe.pdf

Motor Truck Cargo Proposal Form (NY & NJ)* — Required for cargo being transported by a trucker 
Adobe.pdf

* Coverage may be offered in the non-admitted market through our Lawrence Excess division. Download and complete the forms below and submit with application.

For NY Risks

Affidavit By Producing Broker
Word Document     Adobe.pdf

Notice of Excess Lines Placement/Total Cost Form
Word Document     Adobe.pdf

For NJ Risks

Certification To Place Risks With Authorized Insurer
Word Document     Adobe.pdf

Notice of Surplus Lines Offering
Word Document     Adobe.pdf

Click here to download Adobe Acrobat Reader for free.

If you have questions regarding these applications, please contact our Commercial Auto & Garage division.


“With Lancer, you deal with real professionals. The underwriters take the time to discuss the merits of the account and utilize creative underwriting principles to help write the business.”
— Michael J. Fleischer, President, Flexible Agency, Inc., Huntington, NY