Alliance of Schools for Cooperative Insurance Programs
ascip
COVID-19
Reopening Schools Planner
About
Calendar
Financial Strength
Governance
Members
News & Updates
FAQ’s
Insurance for Schools
Coverages
Property & Liability
Workers’ Compensation
Health Benefits
OCIP – Construction Insurance for Schools
Request A Quote
Risk Services
Member Shared Resources
Risk Management Prevention Services
Guidelines & Best Practices
Sample Agreements & Forms
Abuse Prevention Resources
Special Education Resources
Risk Alerts & Bulletins
Lessons Learned – Sharing Experiences
Safety Spotlight Resources
Additional Resources and Forms
FAQs
Training
2021 Annual Membership Meeting
Online Training
Seminars & Webinars
Resources
Forms & Tools
Contact
Open Menu
COVID-19
Reopening Schools Planner
About
Calendar
Financial Strength
Governance
Members
News & Updates
FAQ’s
Insurance for Schools
Coverages
Property & Liability
Workers’ Compensation
Health Benefits
OCIP – Construction Insurance for Schools
Request A Quote
Risk Services
Member Shared Resources
Risk Management Prevention Services
Guidelines & Best Practices
Sample Agreements & Forms
Abuse Prevention Resources
Special Education Resources
Risk Alerts & Bulletins
Lessons Learned – Sharing Experiences
Safety Spotlight Resources
Additional Resources and Forms
FAQs
Training
2021 Annual Membership Meeting
Online Training
Seminars & Webinars
Resources
Forms & Tools
Contact
Property & Liability
Home
>
Insurance for Schools
>
Property & Liability
>
Request a Quote
Coverages
Property & Liability
Request a Quote
Optional Coverage
Reporting Claims
Forms and Resources
FAQs
Workers’ Compensation
Request a Quote
Forms and Resources
Viewing and Reporting Claims
FAQs
Health Benefits
Request Health Benefits Quote
Request Health Fair
Affordable Care Act Resources
Forms and Resources
OCIP – Construction Insurance for Schools
Request OCIP Information
Request A Quote
Request a Quote
Property & Liability Program
Download the PDF version of this form
Name
*
Phone
*
District
*
Email
*
Exposure Information
1. General Liability Exposure
P2 Average Daily Attendance (ADA) or Full-Time Equivalent Student (FTES). If you are responsible for insuring students in a special program, students should be included in count (i.e. ROP):
Actual P-2 or Student FTES
Estimated Student Count for Next Year
District Type
K-8
K-12
CCD
JPA
Charter School
Grade Levels
Grade Levels
Liability Deductible Options
Dollar One
$10,000
$25,000
$50,000
$100,000
$250,000
2. Automobile Liability Exposure
Number of Buses:
Number of Passenger and Other Vehicles:
3. Property (Building/Content) Exposure
Building Replacement Value:
Contents Replacement Value:
Date of Last Property Appraisal:
MM
DD
YYYY
Property Deductible Desired:
$5,000
$10,000
$25,000
$50,000
$100,000
$250,000
4. Employee Crime Exposure
Estimated Number of Full Time Employees for Requested Coverage Year:
Estimated Number of Part Time Employees for Requested Coverage Year:
5. Total Payroll
Actual Current Payroll:
Estimated Total Payroll for Requested Coverage Year:
6. Requested Date of ASCIP Coverage:
MM
DD
YYYY
7. Current Year Premium(s) For These Coverages
8. Do you have excess coverage?
Yes
No
Please provide the name of your carrier and your current retention level.
Name of Excess Carrier
Coverage Limits
Additional Comments
Please provide your detailed liability loss run (open and closed claims) in an Excel spreadsheet or similar electronic format for the past 10 coverage years, valued within the past 60 days.
File
Phone
This field is for validation purposes and should be left unchanged.