Trackless Train Application

Standalone supplemental application styled to match the Risk Advisors Insurance application system. This form is based on the Hudson Insurance Group Trackless Train supplemental application and is not connected to the primary party equipment rental application.

Please complete the sections below, review all answers carefully, then sign before submission. This standalone version is intended for customers whose primary operation is trackless train service.
Application TypeStandalone Supplemental
EquipmentTrackless Train
FlowWizard + Review + Signature
Step 1 of 7General business information

1. General Business Information

The ACORD 125 commercial insurance application must also be completed in addition to this supplement.

Carrier Form Basis
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Named Insured Entity Type

2. Trackless Train Information

Complete the train manufacturer, car count, conductor, transport, and signage details.

Equipment Details

3. Venue Details

Complete mall, strip mall, landlord, and route exposure questions.

Venue Questions

Customer Types

4. Uploads & Checklist

Upload train photos and complete the carrier submission checklist.

Uploads + Checklist
Upload Photo of Trackless Train

Please send a photo of your train(s) along with your application.

Submission Checklist

Warranty

It is hereby understood and agreed that if insurance is issued by virtue of completing this application and any applicable supplemental applications, the insurance is only issued in reliance on the applicant’s warranty of answers to the questions above and on any such supplemental applications. If, at the time a certificate/policy is issued and any of the above warranties is in any respect incorrect, including claims or gross receipts, the coverage afforded under the certificate/policy shall, without notice to the applicant, immediately and automatically cease and the certificate/policy shall become null and void. Warranties will survive a certificate/policy if issued.

5. Additional Notes

Use this section for route clarifications, landlord requirements, or event operation notes.

Additional Notes

6. Document Review

Review the application before signing. Use the button below to generate a summary sheet.

Review & PDF
Please confirm that all business information, operational controls, checklist items, and attachments are complete and accurate before proceeding to signature.

Click Generate Review to compile the entered information.

7. Signature & Fraud Warnings

The signature section, warranty reliance statement, and fraud warnings are included below.

Final Step

Applicant Signature

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Draw your signature with mouse or touch.

Applicant Confirmation

Fraud Warnings

General Warning

Any person who knowingly, and with intent to defraud any insurance company or other person, files an application for insurance or statement of claim containing any materially false information, or for the purpose of misleading conceals information concerning any fact material thereto, may commit a fraudulent insurance act which is a crime and subjects such person to criminal and civil penalties in many states.

California

Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.

Colorado

It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages.

District of Columbia / Louisiana

Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

Florida / Oklahoma / Kansas

False, incomplete, or misleading information in an insurance application may constitute a felony or fraudulent insurance act and may result in prosecution, fines, denial of insurance, or civil penalties.

Maine / Tennessee / Virginia / Washington / Maryland / New Hampshire / New York / Pennsylvania

Providing false, incomplete, or misleading information for the purpose of defrauding an insurance company may be a crime and may result in imprisonment, fines, denial of benefits, rescission, or civil penalties. Refer to the original carrier form for full state-specific wording where required.