Submission Requirements

  • Acord 125 (Commercial Insurance) and Acord 130 (Workers’ Compensation Insurance)

  • 3 – 5 years of currently valued loss runs (within 60 days of renewal or start date), except for new ventures and entities less than five years in business

  • Detailed description of operations, and/or website address if available

  • Experience modifier worksheet/modifier factor

  • 3 – 5 years of historical payroll and workers’ compensation premiums

  • Expiring premium information

  • Supplemental forms required for the type of submitted risk:

  • Trucking

  • Roofing

  • Staffing