Applicant Name

State

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Directors And Officers Liability including Employment Practices Liability

Have there been any losses, claims, or known circumstances that could result in a claim in the past three years?

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What does the foundation do?

Does the organization provide any of these services?

Does the organization have a premises they occupy, whether owned or rented?

What is the square footage of the entire building?

Does the organization have members?

What is the total number of active members?

What are the total annual revenues, including funds raised and donations?

How many full-time employees?

How many part-time employees?

How many seasonal/temporary employees?

How many volunteers?