| If
you would like to receive a quotation to join the Risk
Pooling Trust and obtain coverages, please print, complete,
and submit any of these application forms to:
Michael Vollmer or Donna Bertino
Christian Brothers Risk Management Services
1205 Windham Parkway
Romeoville, IL 60446
Fax: 630.378.2508
If you need assistance in completing these forms,
please call Michael Vollmer at 1.800.807.0100 ext.
3024, or Donna Bertino at 1.800.807.0100 ext. 2529.
To view these pdf's in your browser, you will need
to download and install Adobe Reader.
Adobe Reader is a free download. Some files are also
available in Word or Word Perfect format.
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General
Property/Casualty Coverage (80
KB)
Use this application to request a quote to obtain
protection for buildings, contents, automobiles
and general liability.
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General
Property/Casualty Coverage, Word Perfect Document
(.99 MB)
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Workers'
Compensation Coverage (76 KB)
Use this application to request a quote to obtain
protection for compensating employees who become
injured or ill as a result of their employment.
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Worker's
Compensation Coverage, Word Perfect Document
(200 KB)
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Limited
Professional Health Care Services Application
(68 KB)
Use this application to request a quote to obtain
protection against liability claims arising
from licensed practitioners who deliver medical
services.
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Limited
Professional Health Care Services Application,
Word Perfect Document (204 KB)
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Excess
Directors and Officers Coverage
(64 KB)
Use this application to request a quote to obtain
protection against liability claims filed against
your organization as a result of the actions
of Corporate Directors and Officers.
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Excess
Directors and Officers Coverage, Word Perfect
Document (957 KB)
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Automobile
Schedule (9 KB)
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Property
Value Schedule (6 KB)
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Open
to the Public Nursing Home Care Application
(352 KB) |
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Open
to the Public Nursing Home Care Application, Word
Document (723 KB) |
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