CHILD CARE QUOTE FORM
The Quote Form is our preliminary process of obtaining the necessary underwriting information. Be as thorough as possible. The current policy and claim history will also be required as part of the underwriting process.
STAFF and CHILDREN
Highest enrollment counts for previous 4 years? *
Describe field trip activities and procedures *
SWIMMING POOL/WATER CHECKLIST (Complete only if facility has a swimming pool/water exposure on or off premises)
RULES & REGULATIONS
CHILD CARE LEGAL LIABILITY - CLAIMS-MADE BASIS (Complete only if this coverage is being requested)
ABUSE OR MOLESTATION LIABILITY (Complete only if this coverage is being requested.)
Is there anything else that you would like for us to know concerning your up and coming Renewal?
The undersigned authorized officer of the Applicant/Insured entity declares that he/she has read the responses set out in the Child Care Application and that such responses/statements are true and accurate to the best of the officers knowledge and belief.
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