2020 Coverage Documents
Workers’ Compensation
- Master Workers’ Compensation Application
- Board Member Only Application
- Coverage Document
- Excess Workers’ Comp Policy Summary
- Independent Contractor Status Form
Public Entity Liability
- Master Property and Liability Application1
- Operations Exposure Schedules2
- Public Entity Liability Coverage Agreement
- Public Entity Liability Declaration Page
- Sanitation Maintenance Warranty Deductible
- No Fault Water & Sewer Back-Up Opt Out
- Additional Covered Member – Designated Person or Organization
- Additional First Named Member – Designated Sub-District
- Current Member Inactive Special District Status
1. Submit with the appropriate Operations Exposure Schedule.
2. Complete the form that corresponds to your entity type.
Property
- Property Coverage Form
- Cosmetic Damage Waiver Endorsement
- Hail Deductible Endorsement
- Hail Deductible Buyback Endorsement
- Business Income Worksheet
Auto Physical Damage
Equipment Breakdown
Pollution
Crime
- Declaration Page
- Crime Coverage Form – Available Upon Request
