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Our Umbrella's Program

Klein Insurance Services, Inc.

Forms

Some forms are available in a .doc format and can be completed interactively in Word. Download the form, complete the form, save it, print it out, sign it and return it to KIS.

All forms are available in a pdf version. Download the form, print it out, complete it and return it to KIS. If you do not have Acrobat Reader you can download a free version by clicking here.

Supplemental Application

Hotel Application.doc (Word Document) Hotel Application.pdf (Adobe Acrobat Document)

Monoline Umbrella Supplemental Application.doc (Word Document)

Monoline Umbrella Supplemental Application.pdf (Adobe Acrobat Document)


Umbrella Forms

Umbrella Safety Criteria.pdf (use for Risks over 8 stories) or Umbrella Safety Criteria.doc

Acord 125.pdf (Commercial Application)

Acord 126.pdf (GL application)

Acord 131.pdf (Umbrella Section)


Acord Forms

Acord 125.pdf (Commercial Application)

Acord 126.pdf (GL application)

Acord 130.pdf (Worker's Compensation)

Acord 131.pdf (Umbrella Section)

Acord 140.pdf (Property Section)

Acord 141.pdf (Crime Section)

Acord 155.pdf (Boiler & Machinery Section)

Acord 175.pdf (Commercial Change Request)

Statement of Value.pdf

Please note: To obtain a quote we require ACORDS 125 and 131 and loss runs with prior carrier. .


Broker Agreement

Broker Agreement.doc (Word Document) Broker Agreement.pdf (Adobe Acrobat Document)


Crime Application for Condominiums and Homeowners Associations

Crime Application.doc (296kb Microsoft Word Document) Crime Applications.pdf (224kb pdf)


Valet Parking Application

Valetparking.doc (296kb Microsoft Word Document) Valetparking.pdf (224kb pdf)


Property Applications and Worksheets

Builder's Risk.pdf and Builder's Risk.xls

Renovation Supplement .pdf

EDP (Electronics & Telecommunications) Application.pdf

Hotel BI Worksheet.pdf

DIC.pdf

EPLI Application.pdf

EPLI Renewal Application.pdf

 

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