Public Entity Pak Quote Request

Public Entity Check List

*** This check list is not intended for Fire Pak ***

 

Acord Forms Needed

1. Acord  125   Commercial Ins App
2. Acord  126   GL (min GL limits are 2mill/5mill unless Umbrella is involved then 1mill/5mill)
3. Acord  127   Auto Business (need driver’s info & Vin #’s)
4. Acord  130   WC
5. Acord  131   Umbrella (If client needs more than 2mill per occurrence)
6. Acord  137   Auto Non-Owned & Hired
7. Acord  139   Property Statement of Values
8. Acord  140   Property (Loc #, address, co ins, ded, construction, sq ft, value, yr built)
9. Acord  146   Equipment Floater Section (Inland Marine)

 

 

Supplemental Forms Needed

1.   Public Entity Pak Liability Supplemental App –  AP PE 01 07 08  ( 3 pages )

 

**  If a PEP Supp App question is answered “Yes”, then typically the app will instruct you to complete an additional survey.  These surveys can be found on our website on the right hand side of the homepage **

      

1. Public Officials (E&O) Supplemental App  – AP PE 04 07 08

 

1. Employment Practices Liability (EPL) Supplemental App – AP PE 02 07 08 (optional coverage)

  

1. Electrical Stand-by gen plant 10 mgw max/sub-stations/ transformers (physical damage only )

CW 34 06 07 08

1. Electrical Stand-by gen plant 10 mgw max/sub-stations/ transformers (Mechanical Breakdown)

CW 34 13 07 08