Application Form

General Liability

General Liability coverage protects you from lawsuits if someone was injured at one of your organization's activities and held you responsible. Some activities covered include skating parties, fall carnivals, bounce houses, dunking booths, fun runs, auctions, and more. Injuries resulting from transportation are not covered.

Extended Medical Payments

General Liability coverage also has a separate component that gives insureds access to a minimum of $5,000 in Medical Payments. This is for injuries sustained at one of your organization's activities even if no lawsuit has been filed.

Media Liability

Media Liability coverage is designed to protect you from liability in the event you accidentally misuse or disclose information on your website or other social media site. This includes misuse of logo, copyright, pictures, confidential information and other misrepresentations or misappropriations.

Fidelity Bond

Bond coverage protects your money. It covers anyone who your organization trusts with the money whether it's a President, Treasurer, board member, volunteer, or courier. If that person embezzles (runs off) with your money, Bond coverage would replace those missing funds.

Property (Inland Marine)

Inland Marine (Business Personal Property) coverage protects your raffle merchandise, auction items and fundraising supplies while in your possession. This coverage also protects any personal property of your organization such as popcorn machines, snow cone makers, school store supplies, emergency relief supplies, and more.

Professional Liability
(Officers Liability)

Officers Liability coverage protects the organization from lawsuits for "wrongful acts". If someone sued the officers of your organization for mismanagement, misrepresentations, dissemination of false or misleading information, or inappropriate actions this coverage would pay to defend you against those actions.

Please select the desired coverage and click Purchase Coverage below.

  • Educator's Professional Liability
    $1 Million Limit - $55.00

Media Liability, Medical Payments, or Utah Tort limits are only available in combination with General Liability Coverage

Fields marked with a * are required.
* Organization Name :
District : Council :
* Address :
* City : * State : Texas * Zip Code :
* Phone : Fax :
* Email : * Confirm Email :
* First Name : * Last Name :

Have you had insurance declined, cancelled or non-renewed in the last three years?"
Yes No
If yes, please provide details:

Have you had any insurance claims in the last five years?"
Yes No
If yes, please provide details:

Please note that all policies are subject to a minimum premium of 50% or $50, whichever is greater, not to exceed the total annual premium. Policies cancelled before the effective date, are subject to a $35 cancellation fee. All premium and fees are fully earned at inception.

Requirements of bond coverage (make sure all officers are aware of requirements):

  1. The Organization must conduct an annual review of the books by a Review Committee or qualified accountant.
  2. The monthly bank statement must be initialed and reviewed by someone who does not have authorization to sign checks.

COVERAGE IS VOID IF THESE REQUIREMENTS ARE NOT FOLLOWED.

  • I understand that coverage does not apply to any individual having previously been convicted of a crime related to improper sexual conduct and listed in the Dru Sjodin National Sex offender website.
  • I certify that there have been no losses, accidents or circumstances that might give rise to a claim, that have not already been reported for a coverage(s) for which I am applying.
  • I acknowledge that AIM may contact me or my organization by email.
  • I agree to the terms and conditions of the policy as set forth in this application

ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND CIVIL PENALTIES.

     
AIM Association Insurance Management PO Box 674051 Dallas, TX 75267-4051
(800) 876-4044 fax (214) 360-0802