"Our success is not because of the coverage we offer. It's because of the people who write the policies."

Commercial Umbrella-Excess Indication - Starstone - AIG

Agency Name:
Agency Contact: Fax:
E-mail Address:
Applicant Business:
State: Zip:

Policy Details

Coverage Limit Requested:
Effective Date:

Expiration Date:

What Underlying Coverages Are We Writing Over:
General Liability premium:
Number of Autos:
Workers' Comp. Premium:

Description Of Operations

Description Of Operations:
Annual Sales:
Annual Payroll:

Pre-Qualifying Questions

All Underlying policies are on occurrence forms: Yes No
All underlying policies are written with carriers rated A- V or higher by A.M. Best: Yes No
Have there been any losses in the past three years for any of the coverages being provided?: Yes No
Does the auto fleet exceed 10 Extra Heavy Trucks or 25 total vehicles?: Yes No