Security Guard & Investigation Firm Application

Company Name:
Qualified Licensee:
Website:
Address:
Do you maintain additional offices or other locations?
If YES, please list addresses:
Person to contact:
Title:
Phone:
-
Fax:
E-mail:
Date:
 /  / 
License #:
Considered:
Do you currently or have you ever operated under another name?
If YES, what is the Name and Date established of the entity?
Principal:
Experience:
In regards to your clients, do you assume any duties not related to security (e.g. monitoring pressure control or temperature control, valet services or janitorial)?
If YES, please describe:
Do you subcontract out work to others?

If YES, answer the four (4) questions below.  If NO, leave them blank.


1) What type of operation are you subcontracting?
2) What is your total cost of subcontracted work?
3) Do you require certificates or proof of WC or GL coverage from your subcontractors?
4) Are you named as an additional insured on all subcontractor policies?
Do you have a training program for new employees?
If YES, please describe here:
Does your Pre-Employment screening include:
Total number of employees:
How many worked full time:
How many worked part time:
How many were armed:
How many were unarmed:
If you have armed employees, briefly describe your gun control program:
Are all armed personnel properly licensed and certified?
Do you operate a fee based security training school for guards that are not your employees?
Do you sell products?

If YES, answer the bottom three (3) questions.  If NO, leave blank.


1) What type of products do you sell?
2) How are these products distributed?
3) What are the annual gross sales associated with these products?
Do you perform fee based credit checks or pre-employment screening services for other companies?
Do you provide alarm installation/monitoring/service or CCTV/Access TV Installation/monitoring/service?

SECURITY GUARD OPERATIONS ONLY


Number of supervisors:
Number of guards:

Total number of guard hours billed to clients ANNUALLY:


Armed:
Unarmed:
Do you utilize dogs?

If YES, please answer the bottom two (2) questions.  If NO, leave blank.


1) # of dogs:
2) Are all dogs attended by trainers:
Do you utilize mobile equipment (golf/security carts)?
If yes, what is your policy with regard to transporting non-employees?
Do you have a standard client contract?

If YES, please answer the two (2) questions below.  If NO, leave blank.


1) Percentage using standard contract?
2) Before use, are contracts reviewed by counsel in each state in which you operate?
Do you have a standard written procedure for reporting incidents?

Equipment: Are security officers provided with any of the following equipment prior to starting a post?


Aerosol chemicals:
Handcuffs:
Night Stick - Standard:
Flashlights:
Five cell flashlights:
Five cell flashlights:(1)
Night Sticks - PR24 or ASP:
If YES to any of the above, are officers trained according to applicable state laws?

INVESTIGATION ONLY


Do your final reports include recommendations or an appropriate course of action?
If involved in background/credit checks, are all employees trained in fair credit reporting act compliance?
Does your firm have procedures in place to protect against clerical errors?
Does your firm attach standard disclaimers to all completed reports?

GENERAL LIABILITY SECTION


Client Name:
Effective Date (start):
Effective Date (end):
Check if Limit of Liability Desired is:
If a different number, how much?
During the past five years have any claims been presented to your present or prior insurer?
Do you have any knowledge concerning any incidents that have occurred prior to the date of this application which may result in a future claim?
If YES, please provide details:
Has your liability insurance ever been canceled, declined or non-renewed in the past three years?
If YES, explain:
Total Number of Clients:

Please provide a list of your 5 largest clients along with a brief description of services provided:


1) Client Name:
1) Description of Service:
2) Client Name:
2) Description of Service:
3) Client Name:
3) Description of Service:
4) Client Name:
4) Description of Service:
5) Client Name:
5) Description of Service:

Additional Coverages


Do any of your clients, by virtue of written contract, require any of the following:
Certain extensions of coverage are available for an additional premium. Please check below if you would like quotes to include the following extensions (subject to underwriting approval).

SUPPLEMENT APPLICATION - complete this section if you have operations in any of the categories.


Clients Name:

Schools and Colleges


List the names and addresses of the schools where you are providing security.


1) School Name:
1) School Address:
2) School Name:
2) School Address:
3) School Name:
3) School Address:
Do your duties require that you security check students entering any building?
Any work at dormitories or student housing?
Do security officers have arrest or detention authority?
Do security officers working at schools receive site specific pre-screening and training?

SHIPPING PORTS, PIERS, MARINAS
List the name(s) of the ports, piers or marinas where you are providing security along with a description of your work.


1)
2)
3)
Do you provide work at Detention Areas - detain illegal immigrants?
Do you provide assistance to passengers with disabilities? (transport on carts or wheelchair assistance)
Do you provide passenger screening or screening of any personnel?
Do you provide baggage screening or X-Ray services?
Do you provide screening of cargo or take custody of any cargo?

AIRPORTS
List the name(s) of the Airports where you are providing security along with a description of your work.

1)Airport
2)Airport
3)Airport
-Do you provide work at Detention Areas - detain illegal immigrants?
-Do you provide assistance to passengers with disabilities? (transport on carts or wheelchair assistance)
-Do you provide passenger screening or screening of any personnel?
-Do you provide baggage screening or X-Ray services?
-Do you provide screening of cargo or take custody of any cargo?

COURIER/TRANSPORT

Who are your clients for this exposure and what is being transported?
Is there separate coverage for loss or damage to the items being transported?
Do you have separate Auto coverage in place for operation?

HOUSING/RESIDENTIAL
Please list the addresses to all residential locations where you provide security.

1) Residential Address:
2) Residential Address:
3) Residential Address:

EXECUTIVE PROTECTION/BODYGUARD SERVICES

Do you provide security for any public figures (celebrities, entertainers, sports figures, politicians)?