Vehicle Information Form

Annual Vehicle Insurance Information
As a member of Bolin’s Contact Field Services or Pipeline Inspection team, you are required to supply HR with a copy of your auto insurance policy each year. Liability coverage must be at least $100,000/person and $300,000/accident.
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Name
Do you have multiple vehicles on the policy?
Click or drag files to this area to upload. You can upload up to 3 files.
Please upload your policy and your insurance card. The policy can be the page or pages that specifically outline the liability coverages and does not necessarily have to be the full policy. Contact Deb Bohannon with any questions.
Click or drag files to this area to upload. You can upload up to 2 files.
Please upload a copy of your driver’s license if it has been changed since your hire date.
Click or drag files to this area to upload. You can upload up to 2 files.
Please upload a photo that can be used for your headshot if we do not already have one on file. Preferably, it will be done with a light background and without a hat.