Municipal Entity Underwriting Application
Unique Extensions or Exclusions
Do you distribute a written handbook/explanation of all employee benefits?
If yes attach a copy of the handbook.
Do you have a full-time trained human resource person?
Have you had any claims for administrative E&O or negligent acts?
If yes include detail in loss run summary
Do you have knowledge of any future claims?
If yes provide details.
Automobile Liability Information
22 of 3410/23/2007