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Agreement to Furnish Insurance
This agreement is made on {date} between {Seller}, hereafter "Seller," and {Buyer}, hereafter "Buyer":
This agreement refers only to the motor vehicle listed here, the title of which is being transferred from the Seller to the Buyer on {date}: {Make and Model}, {Color and Year}, {Plates (if applicable) and State}, {VIN}.
The Buyer hereby agrees to furnish insurance for the aforementioned vehicle no later than {date}. This insurance policy must include {requirement}, and the Buyer must supply the Seller with the full details of the policy no later than {date}.
If the Buyer does not furnish insurance in the allotted time above, the Seller will procure an insurance policy that covers {requirement}, and the Buyer will repay the Seller for the cost of the premium(s).
Buyer _________________________ Date __________
Seller _________________________ Date __________
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