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Municipal Entity Underwriting Application

5.

Indicate the type of training received by emergency personnel.  

6.

How many calls does the insured answer per month?  

7.

Does the insured’s organization have a clearly defined chain of command?

 Yes

 No

8.

Who is responsible for the final decision in an emergency situation?

9.

Do nurses carry their own professional insurance?

 Yes

 No

LAKES, RESERVOIRS OR BEACHES

1.

Describe location.   

2.

What is the area of the lake, beach or reservoir?

3.

Is swimming allowed?

 Yes

 No

4.

Is the swimming area roped off?

 Yes

 No

5.

Are Certified Lifeguards on duty during swimming hours?

Number of Lifeguards on duty?  

 Yes

 No

6.

Is any boating permitted near the swimming area?

 Yes

 No

7.

Are scheduled swimming hours clearly posted?

 Yes

 No

8.

Is the area fenced?

 Yes

 No

9.

Are there any diving platforms or rafts in any part of the swimming area?

 Yes

 No

10.

If no swimming is allowed, or no Lifeguards on duty, is hold harmless language and warning signs conspicuously posted?

 Yes

 No

11.

Is the beach patrolled regularly during evening hours?

 Yes

 No

MARINAS, WATERCRAFT, WHARVES, PIERS, DOCKS

1.

How many piers, docks, or wharves are owned by your entity?

2.

Area of each (in sq ft)?

3.

Use of each?

4.

Are there boat slips?

 Yes

 No

If yes, how many?

5.

How many piers / docks are anchored?

6.

How often are the piers / docks inspected?

7.

Is there a regular maintenance and upkeep program for the piers / docks?

Please describe.  

 Yes

 No

8.

Is there a marina exposure?

If yes, please describe all operations.  

 Yes

 No

9.

Receipts

10.

Are there any operations subcontracted out?

 Yes

 No

11.

List owned watercraft, including length, usage, and horsepower of each.

Water Craft Description

Length

Usage

Horsepower

16 of 3410/23/2007

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