Get Commercial Umbrella Liability Application Form

Filling out the Commercial Umbrella Liability Application Form online can seem daunting, but with clear guidance, it is a straightforward process. This guide aims to provide you with step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete the application form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor for online filling.
2. Begin by entering your insured account number and selecting the policy term needed. Choose your billing option from the available choices: one pay, two pay, four pay, or monthly. Enter any deposit amount submitted with the application.
3. Provide detailed information about the business, including its name, type (individual, partnership, limited liability company, or corporation), and complete address, including street, city, county, state, and zip code.
4. Indicate your requested coverage effective date and the limit of liability you wish to request, selecting from the options provided or specifying another amount.
5. Fill in the requested self-insured retention where no primary insurance applies. Report the number of years in business, annual sales, number of employees, and annual payroll.
6. Describe your operations and the products you manufacture, handle, distribute, or sell, along with their respective percentage of total sales or receipts.
7. List and provide details for any domestic and foreign affiliated companies and subsidiaries, including their location, operation type, annual sales, and number of employees.
8. If applicable, list any owned or leased aircraft and watercraft over 50 horsepower, including the make and type.
9. Detail all locations leased by the applicant, including how liability is protected and the estimated value of the premises.
10. Document any items of personal property belonging to others that are in the applicant's care, custody, or control, including their value and how they are insured.
11. Describe any contractual liability assumed by the applicant, noting if there is none.
12. Outline any advertising activities planned in the next 12 months, noting if there are none.
13. Complete the section regarding loss history by listing all liability losses during the past five years, including the date, description, and payments.
14. Fill in the schedule of underlying insurance, providing specific coverage types, insurance companies, policy numbers, limits of liability, and annual premiums.
15. Answer the general underwriting questions related to insurance coverage and operations, ensuring to provide accurate responses.
16. Provide any additional remarks in the designated section if needed.
17. Read the notice regarding the Fair Credit Reporting Act and understand the implications before proceeding.
18. Sign and date the application form as the applicant or authorized representative, indicating their title.
19. Complete the agency information section regarding how long you have known the applicant and the agent's name.
20. Once all sections are complete, ensure all questions have been answered to prevent the application from being returned, then save your changes, download, print, or share the form as necessary.

Complete your Commercial Umbrella Liability Application online now.