REQUEST FOR NO OBLIGATION LIABILITY QUOTE

Complete the information below and click the Submit button to send it to UIG Union Insurance Group for a FREE, NO OBLIGATION QUOTE of your labor organization's business insurance.

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UNION: CONTACT PERSON :
STREET ADDRESS: CONTACT TITLE :
CITY: PHONE:
STATE, ZIP: FAX:
POLICY EXPIRATION DATE: CURRENT CARRIER:
DESIRED LIMITS: $500k $1MM $2MM $3MM $4MM $5MM
DESIRED RETENTION: $2,500 $5K $10K $15K $25K OTHER
GROSS REVENUES? DOES UNION ANTICIPATE FILING A TERMINAL REPORT IN THE NEXT TWELVE MONTHS?
DATE OF MOST RECENT OLMS AUDIT NUMBER OF CLAIMS IN LAST 5 YEARS
ANY NEGATIVE OLMS AUDIT COMMENTS?

TOTAL DOLLAR AMOUNT OF PAID CLAIMS
NUMBER OF DIRECTORS AND OFFICERS NUMBER OF DIRECTORS AND OFFICERS 1 YR AGO
TYPE OF ORGANIZATION LOCAL STATE REGIONAL INTERNATIONAL
PLEASE CHECK BOXES APPLICABLE TO YOUR UNION:
PUBLISHES NEWSLETTERS OFFERS JOB PLACEMENT/ JOB REFERRAL
DISTRIBUTES TECHNICAL MANUALS OFFERS INSURANCE BENEFITS OUTSIDE OF COLL. BARGAINING
OFFERS LEGAL AID OFFERS OTHER PROFESSIONAL SERVICES
PLEASE CHECK BOXES APPLICABLE TO YOUR UNION:
SECOND SIGNATURES REQUIRED ON ALL CHECKS FORMAL AUDIT COMMITTEE TO REVIEW PROCEDURES
IN HOUSE LEGAL COUNSEL EMPLOYEE HANDBOOK
PERFORMS BACKGROUND CHECKS ON NEW EMPLOYEES ANTI DISCRIMINATION POLICY IN PLACE
ONE OR MORE BUSINESS AGENTS EMPLOYED RNEY REVIEWS ALL PUBLICATIONS PRIOR TO RELEASE
ATTORNEY ON RETAINER  
DOES THE ORGANIZATION CARRY ANY OF THE FOLLOWING POLICIES:
GENERAL LIABILITY ERRORS AND OMISSIONS
EMPLOYMENT PRACTICES WORKERS COMPENSATION
DIRECTORS AND OFFICERS ERISA FIDELITY BOND