Associations and Not-For-Profit

  • Applicant Information

    * Required
  • (Describe typical services performed, customers served, products provided, etc.)
  • Please describe operations and relationship to the main organization
  • (annual conference, fundrasing activities, etc.)
  • If this applies to you, please describe
  • General Underwriting Questions

  • Current Insurance Information

  • MM slash DD slash YYYY
  • Location / Building Information

  • If over 30 years old, years of updating for

  • Coverage/Rating Basis Information

  • Property

  • Should include Leasehold Improvements(may also be included in building so obtain a breakdown), Leased Property, Inventory, Furniture/Fixtures, Equipment, Printed Materials, Consumables, Property of Others
  • General Liability

  • Worker's Compensation by State

  • Owner/Officer Information

  • Automobile

  • Owned Vehicle Schedule

    NOTE: You may complete with Vehicles and Drivers below, or fax us your list at 301-417-0040

  • Drivers Schedule (if you own vehicles)

    (List all employees who drive any vehicle on company business)

  • Prior Claim/Loss Information

  • Other Optional Coverage to Consider