Founded in 1864. An employee-owned company.

Insurance Applications & Questionnaires

Click to download the appropriate form

To ensure easy access to the forms you need, our team has compiled an easy to browse archive containing all of the forms and questionnaires you will need to apply for commercial and personal business at our branch. Feel free to download the listed forms, and contact us at the information provided with any questions.

 

Insurance Program

Form Download

Contact

 
Business Insurance Business Quote Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440

 

 
Personal Insurance Auto Quote Form (or Submit Online)
Homeowners Quote (or Submit Online)
Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440
 
Disability & Life Disability Quote 
Group Disability Quote 
Life Insurance Quote 

Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440

 

 

In-Home Day Care

In-Home Day Care Questionnaire 
Questionario de Guarderia de Niños
Family Child Care Assoc. of NYS Application 

Kristina Eckhardt
ext. 1007
Tel: 800-724-0695 / 518-943-3900
Fax 518-943-7440
 

 
Cyber Cyber Application Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440
 
 
Restaurants - Special Events Restaurant / Bar Product Application 
Liquor Liability Warranty Application - Bar
Special Events
Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440
 
 
Nonprofits - Insurance &
Risk Management
Nonprofit Insurance Overview 
GET A QUOTE - D&O coverage 
GET A QUOTE - Workers' Comp., Property or Liability 
GET A QUOTE - Group Benefits 
Chubb Works Loss Prevention Program
Chubb Risk Analyzer
Workers' Compensation Application 
NYS Workers Compensation Handbook 
Disability Application 
Property & Casualty Application 
Great American Policy Highlights
Great American Program Overview
Risk Facts Basic for Nonprofits
Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440
 
National Association for
Community Mediation (NAFCM)
NAFCM Directors' & Officers' Application   
NAFCM Professional Liability Application   
NAFCM Property & Casualty Application 
Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440

 

 
North East Fabricare
Association (NEFA)
Dry Cleaner Application  Lorraine Emerick
ext. 1022
Tel: 800-724-0695
Tel: 518-943-3900
Fax 518-943-7440