Animal Rescue Application | Lamb Insurance Services

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Coverage Needed

Select coverage you want quoted*

Select all that apply.

Commercial General Liability (GL)

Animal Rescue Operations

Professional Liability (PL)

Business Auto (Owned Auto)

Hired and Non-Owned Auto (HNOA)

Property

Board & Executive Liability (D&O)

Sexual Misconduct and Physical Abuse Liability (Abuse)

Cyber

I’m Not Sure

Information to pass along

Please enter any information you think would be helpful for our team to know in order to make the best assessment of the insurance you need.

Requested Effective Date

Requested Expiration Date

Quote Needed By

Business Information

Business Name*

DBA (if applicable)

Website Address*

Federal ID Number*

Please submit as XX-XXXXXXX

501(c)(3)

Yes

How many years have you been in business?*

Is Your Business Incorporated?

Yes

If so, What State?

Do you currently have General Liability coverage in place?

Yes

Unsure

Business Contact Information

Name*

First Last

Title

Phone*

Email*

Enter Email Confirm Email

Mailing Address

Address

Street Address Address Line 2 City State ZIP Code

Is Mailing Address Above a Physical Building Address for the Business?

Yes

Physical Building Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is Mailing the Same as Operating Address

Yes

Primary Operating Address

If different from above

Address

Street Address Address Line 2 City State ZIP Code

Do you operate in more than one state?

Please select the additional states you operate in

Alabama

Alaska

American Samoa

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

District of Columbia

Florida

Georgia

Guam

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Northern Mariana Islands

Ohio

Oklahoma

Oregon

Pennsylvania

Puerto Rico

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

U.S. Virgin Islands

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

Armed Forces Americas

Armed Forces Europe

Armed Forces Pacific

Entity & Operations

Type of Organization

Nonprofit

For-profit

Other

Any subsidiaries or affiliated entities?

Yes

Please describe and indicate if coverage requested

Staffing Snapshot

Number of Full Time Employees

Number of Part Time Employees

Number of Volunteers

Number of Independent Contractors

Financial Summary

Annual Revenue (most recent FY)

Annual Expenses (most recent FY)

Annual Payroll

Total Assets (optional but recommended for D&O)

Total Liabilities (optional but recommended for D&O)

Major Funding Sources (multi-select)

Private donors

Foundations

Government grants

Program fees

Events

Other

If Other, describe

Prior Insurance and Loss History

Any claims in last 5 years?

Yes

Upload loss runs (or claim summary)

Drop files here or

Max. file size: 256 MB.

Claim Details

Date of loss

Claim type

Description

Amount Paid (optional)

Amount Reserved (optional)

Corrective action taken

Untitled

Add more

Coverage declined/canceled/non-renewed last 3 years?

Yes

Explain

Any known incidents that could lead to a claim?

Yes

Explain

Commercial General Liability

Limits

Each Occurrence Limit Requested

Aggregate Limit Requested

Current GL

Currently have GL coverage?

Yes

Current GL Insurer

Current GL Effective Date

Current GL Expiration Date

Current GL Premium

Claims-made basis?

Yes

Current Each Occurrence Limit

Current Aggregate Limit

Current GL Dec page

Max. file size: 256 MB.

Exposures

Approx. number of people served annually

Any physical premises/building?

Yes

Locations

Location name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Owned/Leased

Square footage

Primary use

Untitled

Add more

Any exposures involving animals?

Yes

Animal Rescue Operations

Rescue basics

Provide shelter/rescue services?

Yes

Number of kennel/cage spaces available

Number of animals placed in foster annually

Types of animals accepted

Dog

Cat

Small Mammal

Bird

Reptile

Other

If other, describe

Intake and transport

Obtain dogs outside your state?

Yes

Describe sources and states

Foster program

Number of animals placed in foster annually

Dog foster homes

Cat foster homes

Foster application required?

Yes

Foster waiver/hold harmless signed?

Yes

Foster training provided?

Yes

Describe training

Behavior controls

Behavioral eval performed by qualified professional?

Yes

Who performs and qualifications

Accept aggressive animals?

Yes

Provide rehab/training for behavioral issues?

Yes

Describe program

Off-site adoptions

Off-site adoption events?

Yes

How many per year

List typical venues and supervision

Pet store adoptions

Use pet stores as a source for adoptions?

Yes

Pet store details

Store name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Animals housed full-time?

Yes

One-day adoption events?

Yes

Supervision procedures

Pet store details

Add more

Document uploads

Waivers/contracts are not necessary for a quote, but may be required to bind coverage.

Adoption Contract

Max. file size: 256 MB.

Volunteer waiver

Max. file size: 256 MB.

Foster waiver

Max. file size: 256 MB.

Volunteer manual

Max. file size: 256 MB.

Foster procedures/manual

Max. file size: 256 MB.

Professional Liability

Limits

Each Occurrence Requested

Aggregate Requested

Services

Professional Services Providers

Provider type

Employees FT

Employees PT

Volunteers FT

Volunteers PT

Independent contractors FT

Independent contractors PT

Total Revenue For Service

Untitled

Add more

Controls

Use independent contractors?

Yes

Verify licenses/credentials?

Yes

Any license investigations/discipline?

Yes

Explain

Auto Liability

Owned / Leased Autos

Do you own or lease vehicles?

Yes

Vehicle schedule

Year

Make

Honda, Toyoto, BMW, VW, etc.

Model

VIN

Garaging ZIP

Use

Transport animals

Staff errands

Events

Other

Annual mileage

Untitled

Add more

Hired and Non-Owned Auto (HNOA)

Do employees or volunteers use personal vehicles for org business?

Yes

Do you verify personal auto insurance annually?

Yes

Number of drivers using personal vehicles

Driver screening

MVR checks performed?

Yes

MVR frequency

If Other, explain

Property Coverage

Current property

Currently have property coverage?

Yes

Carrier

Effective Date

Expiration Date

Premium

Property dec page

Max. file size: 256 MB.

Locations and values

Property locations

Location name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Square footage

Year built

Construction type

Building limit

Business personal property limit

Untitled

Add more

Any location older than 25 years?

Yes

Updates per location

Location Name

Year roof replaced

Year electrical updated

Year heating updated

Year plumbing updated

Untitled

Add more

Protective safeguards

Property deductible requested (NEED OPTIONS)

Equipment breakdown requested?

Yes

Fire alarm system at all locations?

Yes

Smoke detectors at all locations?

Yes

Smoke detectors serviced semi-annually?

Yes

Fire extinguishers serviced annually?

Yes

Board and Executive Liability

Governance

Number of board members

Annual Board Meetings

Please enter the number of times per year your board meets

Minutes kept?

Yes

Conflict of interest policy in place?

Yes

Conflict of interest policy

Max. file size: 256 MB.

Financial oversight

CPA audit or financial review performed?

Yes

Type

Most recent year completed

Most recent financials or audit

Max. file size: 256 MB.

D&O claims indicators

Any governance disputes, investigations, or allegations in last 5 years?

Yes

Explain

Employment practices

Employee handbook in place?

Yes

Employee handbook

Max. file size: 256 MB.

Anti-harassment policy in place?

Yes

Formal complaint procedure?

Yes

Any employment-related claims or allegations?

Yes

Explain

Sexual Misconduct and Physical Abuse Liability

Employees/volunteers with supervisory or disciplinary authority

Background checks for employees?

Yes

Background checks for volunteers?

Yes

Proof of background checks required for independent contractors?

Yes

Any unsupervised contact with vulnerable persons?

Yes

Formal incident reporting procedure?

Yes

Staff training on recognizing/reporting abuse?

Yes

Written crisis response plan?

Yes

Compliant with mandatory reporting laws?

Yes

Any volunteers under 18?

Yes

Parent/guardian consent required?

Yes

Parent/guardian must be present?

Yes

Any known incidents that could lead to an abuse-related claim?

Yes

Explain

Upload Docs

Upload any related materials you have that would be beneficial for this application

Drop files here or

Max. file size: 256 MB.

Kennel Pak Animal Organization Application

Kennel Pak Animal Organization Application

Coverage Needed

Business Information

Business Contact Information

Mailing Address

Primary Operating Address

Entity & Operations

Staffing Snapshot

Financial Summary

Prior Insurance and Loss History

Commercial General Liability

Limits

Current GL

Exposures

Animal Rescue Operations

Rescue basics

Intake and transport

Foster program

Behavior controls

Off-site adoptions

Pet store adoptions

Document uploads

Professional Liability

Limits

Services

Controls

Auto Liability

Owned / Leased Autos

Hired and Non-Owned Auto (HNOA)

Driver screening

Property Coverage

Current property

Locations and values

Protective safeguards

Board and Executive Liability

Governance

Financial oversight

D&O claims indicators

Employment practices

Sexual Misconduct and Physical Abuse Liability

Upload Docs