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Submissions must include the following:
- Completed
Acord applications, signed by the insured, including
detailed property information to include construction,
occupancy, square footage and age
- WellGuard
Supplemental
Application, signed by the insured
- 5
years of recently valued company loss runs
- Details
on losses over $10,000
- Updated
driver information, including MVR's
- Expiring
premiums and target premiums for all lines of coverage
- Federal
Employer Identification Number (FEIN)
- Complete
vehicle identification numbers (VIN)
If
you are not yet appointed with Willis of New Hampshire,
Inc., please include the following:
- Completed
and signed Broker
Agreement with the following:
- Proof of E&O showing a minimum of $1,000,000 limit per occurrence.
- Copy
of licenses in all states you plan to broker the WellGuard
Program
For More Information on the services and
products offered by WellGuard, and to learn
more about the best ways to address insurable business
risks specific to the ground water industry, contact:
Tim Sullivan, tim.sullivan@willis.com
Willis HRH Programs
One New Hampshire Avenue Suite 200
Portsmouth, NH 03801
Ph: 1-603-334-3078
Fax: 1-603-334-3090
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