• AML Investigators Insurance Application

  • (Complete name as it should appear on the policy including Inc., Corp., Ltd., LLC., Etc...)

    OPERATIONS

    Please provide the percentage of revenue from each type of operation below:
    Business Personal Property Coverage: (Furniture & Fixtures)

    Underwriting Questions

    (IF YOU CARRY FOR YOUR OWN PROTECTION, ANSWER NO)

    Optional Coverage

    (Limit Selected cannot exceed primary liability limits)
    A waiver of subrogation relinquishes your right of subrogation. Clients may want your business to waive your right of subrogation so they will not be held liable for damages if they are partially responsible for a loss.
    This means that the contractor's policy must pay before other applicable policies (primary) and without seeking contribution from other policies that also claim to be primary (noncontributory).
    Prior acts coverage is an insurance policy feature that covers claims made on insurable events that occurred prior to a policy's purchase.
    Applicant's Warranty Statement: The undersigned represents to the best of his/her knowledge and belief the particulars and statements set forth are true and agree that those particulars and statements are material to the acceptance of the risk assumed by the Company. The undersigned further declares that any claim, incident or event taking place prior to the effective date of the insurance applied for which may render inaccurate, untrue, or incomplete any statement made will immediately be reported in writing to the applied for which may render inaccurate, untrue, or incomplete any statement made will immediately be reported in writing to the Company and the Company may withdraw or modify and any outstanding quotations and/or authorization or agreement to bind the insurance. The signing of the Application does not bind the undersigned to purchase the insurance, nor does the review of the Application bind the Company to issue a policy. It is understood the Company is relying on the Application in the event the Policy is issued. It is agreed that this Application, including any material submitted therewith, shall be the basis of the contract should a policy be issued, and may be attached dot and become part of the policy.
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    Coverage is not effective until approved by our underwriters and you receive our written conformation coverage is bound with your effective date and policy number is if you qualify, your effective date will be the date of your expiring policy subject to our receiving this request prior to the expiration date of that policy or if this is the first time you have purchased coverage, the date we approve your application.

    Coverage include:

    Coverage include: General Liability including Bodily Injury, Property Damage, Personal Injury, Professional Liability, Error and Omissions all on an Occurrence Policy Form with an A++ rated Insurer by A.M. Best. See specimen policy for actual terms and conditions.