Road America Independent Servicer/Provider Online Application


In order to keep you in our dispatch system, RAMC must have on file at all times, a copy of your current certificate of insurance. Use the input boxes below to upload it to our files along with your W-9 (Taxpayer Identification Number and Certificate).

(.pdf, .doc, .docx, .xls, .xlsx or image)
(.pdf, .doc, .docx, .xls, .xlsx or image)

When your current coverage expires, please be certain that RAMC receives a copy of your new certificate of insurance. To ensure that we will be updated regularly by your insurer, we kindly request that you make Road America, Inc. and Brickell Financial, Inc. “certificate holders” on your policy.

The minimum insurance requirements for RAMC services are as follows:

  • Worker's Compensation and Occupational Disease Insurance as required by applicable law.
  • Comprehensive General and Automobile Liability Insurance with minimum limits of $100,000 each person and $300,000 each occurrence for bodily injury and $100,000 for each occurrence for property damage or a minimum combined single limit for bodily injury and property damage of $500,000 per occurrence.
  • Garage Keeper's Legal Liability Insurance (including, but not limited to, “On-Hook” Liability Insurance) with a minimum limit of $25,000 and any additional coverage or limit as may be required by applicable law.
  • Servicer shall provide RAMC with a Certificate of Insurance evidencing Servicer's compliance with these insurance requirements.

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