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Janitorial Services Bond Web Application
 
Required information in Bold

Applicant    
Name of Business      
Address (include any branch location addresses in comments below)
Street and Number   
City State Zip             
Business Phone:      
Business Fax:       
Email Address:         
We will email your new bond directly to this email address.
Have you sustained any employee dishonesty losses in the last 6 years?  
Yes No
If so, please give us all the details
Exact Number of Owners 

Are owners to be covered?
Yes No
Exact Number of Employees (Both full and part-time) 
Amount of coverage requested:   
$5, 000   $10,000   $25,000   $50,000   $100,000    
 Subject to $100 deductible.            

Term Requested:    
1-Year Bond 3-Year Bond  
(reduced rate of  2.85 x annual premium)
* Contains a criminal conviction clause
See below for rates
* In order to protect you and your employees against unjustified allegations
of dishonesty, the employee must be convicted before coverage will apply.
Comments
The effective date of the bond will be the date the bond is issued. 
Pay Premium With VISA or Master Card (6% fee added) 
(Required to receive bond via email.). *
Name On Credit Card :
Credit Card Billing Address: (If different from above)
Street Address  
City, State, Zip
VISA or Master Card Account Number      
Expiration Date        
3 Digit Security  Code

Comments/Request

Referred By    

Please Enter "bond10" below

 

 

  
Available Insurance - Blanket coverage on each individual for:  
# of       Emp. $2,500 $5,000 $10,000 $25,000 $50,000 $100,000
Annual 3 Year Annual 3 Year Annual 3 Year Annual 3 Year Annual 3 Year Annual 3 Year
1 - 5 $59 $159 $73 $196 $100 $271 $183 $495 $266 $717 $360 $972
6 63 170 77 209 107 289 196 529 284 765 384 1,038
7 68 184 84 226 116 312 211 571 306 826 415 1,120
8 72 194 89 239 122 330 224 605 324 875 439 1,186
9 77 208 95 256 131 353 239 647 347 936 470 1,268
10 82 221 101 272 139 376 255 689 369 996 500 1,351
11 86 232 106 286 146 395 267 722 387 1,045 525 1,416
12 90 243 111 299 153 413 280 756 405 1,094 549 1,482
13 95 257 117 315 162 436 295 798 428 1,154 580 1,565
14 100 270 123 332 170 459 311 840 450 1,215 610 1,647
15 104 281 128 345 177 477 323 873 468 1,264 634 1,713
16 109 294 134 362 185 500 339 915 491 1,324 665 1,795
17 114 308 140 379 194 523 355 957 513 1,385 695 1,878
18 118 319 145 392 201 542 367 991 531 1,434 720 1,943
19 123 332 151 408 209 565 383 1,033 554 1,494 750 2,026
20 127 343 156 422 216 583 395 1,066 572 1,543 775 2,092
21 132 356 162 438 224 606 411 1,108 594 1,604 805 2,174
22 137 370 169 455 233 629 426 1,150 617 1,665 836 2,256
23 141 381 173 468 240 647 439 1,184 635 1,713 860 2,322
24 146 394 180 485 248 670 454 1,226 657 1,774 891 2,405
25 150 405 185 498 255 689 467 1,260 675 1,823 915 2471

 
*Since this is blanket position coverage, count all employees (including owners/officers if they are to be included in coverage) when computing the premium. Rates are subject to change.  
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