Pullen Insurance Services

Latest News

8-12-09Pullen Insurance will be moving into a new location effective 8/31/09. Our phone and fax numbers will remain the same. Our new mailing address will be:

2560 River Park Plaza, Suite 300
Ft. Worth, TX 76116

7-14-09Don't forget to contact Pullen Insurance for all of your athletic insurance needs! We are "your athletic insurance specialists."

10-29-08Pullen Insurance sponsors trip to Manchester, England to watch a Manchester United game.
Click here to watch a slideshow of the trip.

Please complete the form below to obtain an insurance quote from Pullen Insurance Services. A member of our team will contact you shortly.

Applicant Information

1.	Company Name:
2.	Address:
3.	City:
	State:
	Zip:
4.	Contact Name:
	Contact Phone:
	Contact Email:
5.	Website Address:
6.	Business Type:
	If other, please describe:
7.	Requested Coverage Begin Date:
	Requested Coverage End Date:
8.	Group Type:
	If other, please describe:

Athletic Participant Exposure Information

1. Please provide the annual number of participants for each sport and age group.

Age Group	Sport Played	First Practice Date	Sport End Date	Total Players

If your organization is a sports association or league,
do you also offer camps or clinics?

Underwriting Information

1.	Was the organization formed more than three years ago?
2.	Do you have trampolines over 46"?
3.	If applicable, will the standard safety gear for the sport be used?
4.	Does the organization require Waiver / Release forms from all participants or guardians, if appropriate?
5.	If not, will you institute a program for Waiver / Release forms?
6.	Are cheerleading pyramids ever more than 2 persons high or are spring boards or trampolines ever used?
7.	Does the organization use or sell any type of Martial Arts related weapon?
8.	Does the organization have and enforce written standards regarding Sexual Abuse and Molestation?
	If yes, are you interested in coverage for claims regarding Sexual Abuse and Molestation?

Operations

1.	If the organization owns a venue, do they allow other organizations to use their facility?
2.	Does the organization have a Code of Conduct, Written Regulations and/or By-Laws?
3.	How are league participants transported to events?

4.	Who is responsible for maintaining the field / facilities?

5.	Are the fields/facilities inspected prior to play?
6.	Is alcohol permitted at any event sponsored by the Named Insured?
7.	Does the organization and/or venue require emergency personnel on site at each event?

Claims History

Current Insurance Carrier:

Is there prior insurance coverage?

If yes, when does your current coverage expire?

4.	Has the organization had any general liability and/or sexual abuse/molestation claims and/or incidents in the last 3 years?
5.	If yes, please explain the claim(s).

6.	Has insurance coverage been denied, cancelled or non-renewed during the last 3 years?
7.	If yes, please explain: