Wildland Firefighting Insurance | Associated Loggers

A Wildland Firefighter 12-13-2023

Use this form to quote a variety of insurance policies if your business is contracting to or actively fighting wildfires. Most all General liability and loggers broad form policies to not cover the activity of fighting wildfires. This is especially true for Commercial Auto and Inland Marine. If you need time to gather all the information required we highly suggest you register and login then start on this application so you can use the “save and continue later” feature. You information will be stored for a short period of time in an encrypted method with three firewalls for your security. Call 209 223-1870 with any questions.

Inspection Contact Name	Office Phone Number	Email	Mobile Phone Number	Email	Is the contact Person the same for Accounting information?	Account Contact Name	Is there someone different that handles the claims?	Email	Claim Contact Name	Claims Person’s Phone	Claim Person’s Email	Actions

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Address	What is your interest in this location?	Number of full-time employees at this location	Number of part-time employees at this location	Estimated Annual Revenue from this location	Is it open to the public?	Total Square Footage of this location	Actions

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Location City County Zip	Class Code	Categories, Duties, Classifications	Full-Time or Part-Time	SIC Code	NAICS	Estimated Payroll	Rate Paid	Actions

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Year	Carrier	Policy Number	Annual Premium	Amount Paid	Is this claim still open?	Amount reserved	Actions

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A Wildland Firefighter 12-13-2023

SELECT ALL STATES OF OPERATION

Workers Compensation Application

Inspection, Accounting & Claims Personnel

OTHER COVERAGES

Business "Physical" Location(s)

Officers, Partners & Relatives

Rating Info.

Insurance History

State the Nature of your Business and Description of Operations

General Information