Professional Forester's General Liability Application
click here to download a PDF application that can be mailed or faxed.
If you have any questions, problems, or concerns
please contact Outdoor Underwriters at 1-866-961-4101.
Company Information |
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Name of Company* | Email Address* | ||
Representative* | Main Number* | ||
Mailing Address* | Mobile | ||
Fax | |||
City* | |||
State* | How did you find us?* | ||
Zip* | Please describe | ||
Location Address | |||
Business Form* | |||
Desired Effective Date* |
Commercial General Liability (Occurrence Form)
Deductible $500.00 Property Damage & Bodily Injury per claim
General Aggregate | $ |
Products & Completed Operations Aggregate | $ |
Personal & Advertising Injury | $ |
Each Occurrence | $ |
Damage to Rented Premises (each occurrence) | $ |
Medical Expense (any one person) | $ |
Foresters Special Liability | $ |
Insurance Carrier | Limits of Liability | Premium | |
Last Year | |||
Two Years Ago | |||
Three Years Ago | |||
Describe any past losses Please include as much detail as possible including dates, descriptions of incidents, reserves, and amounts. |
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Name | Complete Address | ||
Interest |
Number of Forestry Employees* | Total Forestry Payroll* | $ | |
Number of Executive Officers* | Total Executive Officer Payroll* | $ | |
Sub-Contractors Cost | $ | ||
What activities are subs used for? | |||
What percentage of your business is control burn?* |
- All brochures describing any and all services; or website address above.
- Three years hard copy Loss Runs, if unavailable, provide a no loss letter signed by insured.
You can upload your documents below or email them to [email protected] or fax them to 803-451-5695.
Is Applicant a Graduate, Registered Forester? | |
Give a brief description of applicant’s activities and Operations |
Does the applicant: | |||
Use subcontractors? | * | ||
Work in populated or urban areas? | * | ||
Lease any premises? | * | ||
Operate business on a part-time basis? | * | ||
Draw plans, designs or specifications other than forest management? | * | ||
Use explosives? | * | ||
Own, operate, or lease aircraft or watercraft? | * | ||
Use/distribute/mix/apply pesticides or herbicides? | * | ||
Lease equipment to others? | * | ||
Employ seasonal or migrant labor? | * | ||
Perform work underground? | * | ||
Perform tunneling/excavation/earth moving work? | * | ||
Perform or subcontract logging operations? | * | ||
Perform control burns? | * | ||
Maintain Certificates of Insurance on all subcontractors? | * | ||
Employ only salaried employees? | * | ||
Have formal maintenance and safety programs in effect? | * | ||
Comply with all applicable OSHA standards? | * |
Are you a member of Association of Consulting Foresters (ACF) or Society of American Foresters (SAF)? If so which one: |
Any other information carrier needs to be aware of? |
Payments are accepted over the phone via Visa, MasterCard, or by Check/Money Order in the mail.