Transcription of Religious Institution Supplemental Application
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Religious Institution Supplemental Application
*To be able to save this form after the fields are filled in, you will need to have Adobe Reader 9 or later. If you do not have version 9 or later, please download the free tool at: Religious Institution Supplemental ApplicationPage 1 of 5 Section I Submission RequirementsSection II organization Profile (brief summary of the Religious Institution s operations) ACORD applications Applicable to All Lines of Coverage Most recent 990 report if available Currently valued prior carrier loss history 4 years or no known loss letterSection III Life SafetyDo all of the Applicant s facilities have the following life safety features?(Indicate any locations, which do not have the following features)1. Fire alarms? Yes No2.
Supplemental Application. Page 1 of 5. Section I – Submission Requirements Section II – Organization Profile (brief summary of the Religious Institution’s operations) • ACORD Applications Applicable to All Lines of Coverage • Most recent 990 report if available
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