Index for Online Forms

To view and print forms you will need Adobe Acrobat.


Property and Liability Forms

Claims 1st Notice of Loss Forms

Underwriting Forms


Property and Liability Forms

• Primary & Excess Liability Program - New Member Application
• Property Pool - New Member Application
• Request for Liability & Property Certificate of Insurance (PDF Format) (RTF Format)
• Vehicle Change Form
• Application for K-9 Coverage
• Prisoners/Work Release Endorsement Spread Sheet
• Preventive Maintenance
• Training Grant Application
• Skateboard Park Waiver Release
• Maintenance Log
• Citizen Complaint Log
  

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Claims 1st Notice of Loss Forms

• Vehicle Accident Kits - For Members' scheduled vehicles glove compartments.
• Vehicle Accident Report (PDF Format) (RTF Format)- Auto Liability, Auto Physical Collision and Comprehensive claims, and Uninsured Motorist endorsements.
• Personal Injury Protection Benefits Report Auto Physical PIP endorsements.
• General Liability Report (PDF Format) (RTF Format)- General, Public Official and Police Legal Liability claims, and Sewer Backup endorsements.
• Property/Equipment Breakdown Report (PDF Format) (RTF Format)- Property and Equipment Breakdown (formerly Boiler & Machinery) claims, and Builders Risk and Zone A endorsements.

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Note: The above forms must be downloaded and filled out manually. Members who wish to order bulk supplies can contact Charise Henderson, Claims Administrative Assistant, by phone at 1-800-673-8231 ext. 721, or by email at claim@lgit.org