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Search for:
Florida Charter / Private School Insurance Quote
Step
1
of
7
- General Information
14%
Name of School:
Year School Opened:
Current Sponsor:
Business Manager or Principal's Information
Name:
Email
Phone:
Fax:
Cell Phone:
School Insurance Information:
Renewal Date:
Current Insurance Carrier:
Current Property & Casualty budget/cost:
Current Health Insurance Carrier:
Current Health Insurance budget/cost:
Physical Address of School Building(s):
Type of School:
Select
Charter
Public
Private
Grade Levels:
Mailing Address of School Building(s) (if different than physical address):
Approximate year of original building construction:
Date of additions:
Construction of buiding (i.e. wood frame, brick, stone, block, etc.):
Number of stories in the building:
Is Building:
Select
Owned
Leased
Plumbing:
Electrical:
Heating / AC:
Roof
Approximate square footage of building (do not include basement):
Approximate square footage of basement (if applicable):
Does the building have a working boiler?
Select
Yes
No
Does the building have a working boiler?
Select
Yes
No
Is the building sprinklered?
Estimated 100% replacement cost of building of building (or current insurance value):
Estimated 100% replacement cost of business personal property (desks, furniture, books, etc.) DO NOT INCLUDE COMPUTERS in estimate:
Estimated 100% replacement cost of computer hardware:
Estimated 100% replacement cost of computer software:
Estimated 100% replacement cost of improvements and betterments made to the building for school occupancy (i.e. carpet, lighting, alarms, etc.):
Law Enforcement Liability Coverage
Does your school have security guards?
Select
Yes
No
If yes, how many guards?
Are guards armed?
Select
Yes
No
Are they on premises during school hours?
Select
Yes
No
Are they on premises before/after regular school hours?
Select
Yes
No
School Leader Errors and Omissions Professional Liability
Is your Board a Not-For_Profit 501-C3?
Select
Yes
No
Number of board members:
ATTACH A COPY OF YOUR LAST BUDGET or LAST FINANCIAL STATEMENT
Accepted file types: jpg, gif, pdf, doc, txt, docx, Max. file size: 32 MB.
Accepted formats are .pdf, .doc, .txt, .jpg, or .gif
ATTACH A SAMPLE EMPLOYMENT APPLICATION
Accepted file types: jpg, gif, pdf, doc, txt, docx, Max. file size: 32 MB.
Accepted formats are .pdf, .doc, .txt, .jpg, or .gif
Do you have written procedures that facilitate prompt recording and reporting of claims, complaints, charges, and incidents that can be reasonable be expected to result in claims?
Select
Yes
No
Are these procedures communicated to all your members, employees, student teachers and volunteer workers?
Select
Yes
No
Sexual Misconduct and Molestation Coverage
Do you have a written statement of policy that any act of physical or sexual abuse is not tolerated?
Select
Yes
No
Do you have written procedures that facilitate prompt recording, reporting and investigation of and restonse to complaints of sexual misconduct or molestation?
Select
Yes
No
Are these procedures communicated to all staff, student teachers and volunteers?
Select
Yes
No
Have any of your members, trustees, employees, student teachers or volunteer workers ever be accused, charged, convicted, or had claim for damages or suit broght against them for any type of sexual misconduct?
Select
Yes
No
If yes, please explain:
Loss History
Briefly Describe any losses in the past 3 years ( We will eventually need "Hard Copy" loss information from your current insurer for us to release premium figures -- Please request loss runs from your existing agency or insurance company.)
General Liability
Number of teachers:
Number of teacher's assistants:
Number of administrative staff:
Number of students:
Are bleacher/grandstand inspections NFPA 102 compliant?
Select
Yes
No
Number of bleachers:
Food Service: Does your school prepare meals for students on premises and is equipment UL 300/NFPA 96 compliant?
Select
Yes
No
Swimming Pool?
Select
Yes
No
Are rules posted?
Select
Yes
No
Is a lifeguard on duty at all times?
Select
Yes
No
Is pool locked after school hours?
Select
Yes
No
Number of pools:
Vocational Science Programs: Does your school provide Vocational Curriculum?
Select
Yes
No
Number of Children:
Does your school have a written Human Resources Manual including Harassment/Sexual Abuse Policy and Grievance Policy, etc.?
Select
Yes
No
Coverage Limits Desired?
Limits of General Liability Required:
General Liability Per Occurrence Limit: $1,000,000
General Liability Aggregate Limit: $2,000,000
Student Accident Insurance: $5,000 / $10,000
Automobile
Do you have owned or leased automobile(s) or bus(es)?
Select
Owned
Leased
Both
Vehicle Info (please attach a list if more than one):
Accepted file types: jpg, gif, doc, docx, pdf, txt, Max. file size: 32 MB.
Acceptable formats: .pdf, .doc, .docx, .txt, .jpg, .gif
Year:
Make:
Model:
Is Vehicle:
Select
Owned
Leased
Cost of vehicle when it was brand new:
Number of passengers vehicle can carry:
Vehicle usage:
Select
Daily
Field Trips / Special Occasions
Limits
Umbrella Liability Limit:
Select
$1,000,000
$2,000,000
$3,000,000
$5,000,000
$10,000,000
$25,000,000
$35,000,000
$50,000,000
Crime & Employee Dishonesty Limit:
Select
$50,000
$100,000
$250,000
$500,000
$1,000,000
Workers Compensation & Employee Liability Limit:
Select
$250,000
$500,000
$1,000,000
$2,000,000
FEIN (Federal ID#):
Annual Teacher Payroll:
Annual Administrative Payroll:
Annual Custodial Payroll:
Annual Drivers Payroll:
Annual Security Payroll:
ATTACH WORKERS COMP. CLAIMS or LOSSES
Max. file size: 32 MB.
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