Johannes/ STOERMER Co. -- Commercial & Personal Specialty Lines

Applications

We are underwriting and placement professionals for commercial and personal "specialty" insurance risks. We do not have production requirements. You can do business with us EASILY by mailing or faxing applications.

Below is a list of the policy applications that are available for you to download or print. These forms are available for the most part in two versions -- Adobe PDF and Microsoft Word for Windows. You need to have Adobe Reader on your computer to view the forms in the Adobe version. If you do not have this software, it is available for you to download (see below). To view the "word" format, you need the Office 97 version of Word or a word processing program that is capable of translating Word, Office 97 version. Please note that all of the Acord Forms and Applications are only available in an Adobe format. These are on a separate page, and there is a link below for those forms and applications.

For instructions on how to save these files to your computer or to print it out, click here

For ACORD forms, click here.


Document NameStufferApplication
Adult Day Care
Alarm Installers Program
Bailee's Customers  
Beau-T-Pak Program
Builders' Risk Program
CIC Alarm Supplement    
Comprehensive Personal Liability    
Condominium Unit Owner & Tenants Product Application    
Contractors Application    
Contractors Equipment
Day Care Supplement
Demolition Application    
Dwelling Application    
Essex Terrorism Insurance    
Excess Personal Liability Application    
Exhibition Floater  
Family Dwelling Product Application    
Garage Policy  
Great Guard Program    
Great Midwest Great Guard Program  
Habitational Supplemental Questionnaire    
Haunted House Application  
Health Club Pak Program
Hole-In-One Application    
Home Based Business Application    
Home Health Application    
Homeowner Application    
Instructor Pak Program
Landscapers Program
Liquor Catering Plus Supplemental    
Liquor Founders Insurance    
Liquor Mt. Vernon    
Non-Profit D & O Application  
Non-Profit Professional Liability Application    
Nurses Professional    
Omega Terrorism Insurance    
Pawn Sales Supplemental  
Personal Inland Marine Application    
Personal Inland Marine Supplemental Application    
Personal Umbrella Application    
Pet Pak Program
Pre-Cut Christmas Tree Lot
Restaurant / Bar / Nightclub  
Salvage Yard Supplemental  
Security Guard Application    
Special Event - Liquor Supplemental  
Special Event - Mount Vernon    
Special Events / Spectator  
Spray-In Bedliners Supplemental  
Sun Tanning  
Surplus Lines Affidavit for State of Ohio    
Towing Operations Supplemental  
USLI Liquor    
USLI Off-Premises Liquor Supplemental    
USLI Special Event    
Vacant Commercial Property Program
Vacant Dwelling  
Warehouseman Liability  
Welding Supplemental    
Wellness Pak Program
WHIC Special Event Supplemental    



Accord Forms

Form Name#
Commercial Lines
Commercial Insurance Application125
Fraud Statement63
Additional Interest45
General Liability Application126-S
Contractor Supplemental Application186
Restaurant/Bar/Tavern Supplemental Application185
Certificate of Liability25-S
Commercial Property
Commercial Insurance Application125
Fraud Statement63
Additional Interest45
Property Section Application140
Supplemental Property Application190
Statement/Schedule of Values139
Accounts Receivable/Valuable Papers Application145
Crime Section Application141
Glass and Sign Supplemental Application144
Miscellaneous Crime Coverage Section Application151
Certificate Property24
Commercial Inland Marine
Commercial Insurance Application125
Fraud Statement63
Additional Interest45
Equipment Floater Application146
Installation/Builders Risk Section Application147
Electronic Data Processing Section Application148
Commercial Auto
Commercial Insurance Application125
Fraud Statement63
Additional Interest45
Commercial Umbrella
Commercial Insurance Application125
Fraud Statement63
Additional Interest45
Umbrella Section Application131
Policy Service / Other
Cancellation Request / Policy Release35
Statement of No Loss37
Insurance Binder75-S
Policy Change Request175
Statement of Premium Adjustment226
Claims
General Liability Notice of Occurrence3
Property Loss Notice1
Automobile Loss Notice2
Auto Accident Information Form11
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