To obtain a quote
Our ability to provide the best terms and conditions for a club is based upon receiving
a complete and timely submission. While we endeavor to provide our best quote and
coverage conditions the content of the submission we receive usually dictates how
effectively we can underwrite the risk. To aid you in the new business submission
this checklist is available with our applications.
- Completed Acord Applications that are signed by the broker on all lines of business
that are being submitted (including the Club's FEIN number).
- A completed and signed Bollinger Club Questionnaire.
- A complete COPE (construction, occupancy, protection, exposure) including number
of stories, square footage and year of construction for all buildings to be covered.
If the main building is older than ten years please provide renovation dates and
- Four-year hard copy company loss runs for each coverage line to be quoted.
- Most recent audited financials or income and expense statement.
- Auto Acords must include a copy of driver(s) MVR and zip codes for each vehicle.
- A schedule of the Club's maintenance equipment with Replacement Cost Values.
Completed and signed applications must be provided if a quote is requested for any
of the following coverage:
- Limited Pollution Liability
- Pollution Liability for Above Ground Storage Tanks
- Directors & Officers Liability, including Employment
Practices Liability (not for profit/for profit available)
- Fiduciary Liability
Contact us at:
Executive Vice President
Bollinger Club Program
101 JFK Parkway
Short Hills, New Jersey 07078
Electronic new business submissions should be sent to