DHH Insurance Agency, LLC

DHH Insurance Agency, LLC

Call: 1.866.371.8830

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A Division of C.H. Insurance Brokerage, Inc.www.chinsurance.cc

Sign Language Interpreter Agency Insurance Program

About Your Business

Launching and running an Interpreter agency can be one of the riskiest undertakings in life. Insuring your business from financial disaster will guarantee that all your hard work and long hours will be protected.

Every business is unique and customized. By filling out this form, we can obtain a business insurance proposal and have a representative contact you for review.

Please take a few moments and fill out the form below. The more information you can provide to us, the better it helps us to review your business insurance needs. All information is strictly confidential and is used for informational purposes only.

Instructions:
A. Please answer ALL the questions.
B. This supplement must be signed and dated by the prospective insured and will be attached to the policy, should one be issued. A digital signature will be used on the online application.

* Denotes Required Fields



Personnel

Number of Full Time Employee Staff Interpreters

Number of Part Time Employee Staff Interpreters

Number of Independent Contracted Interpreters


Certifications

What percentage of your Employed Staff and/or Contracted Interpreters have completed and passed the RID written & performance test for:


What percentage of your gross annual revenues are derived from the following Interpreting materials or Client Types:

  • Total 100%



How do you manage your appointments/assignments?



Dates of agency's current fiscal period:

Fiscal Total Gross

Revenue


Were more than 50% of your total gross billings for any one year derived from a single client or contract?


Name your agency's 5 largest jobs during the past 3 years:


Does your Firm secure a written contract or agreement for every request(s)?

(Please attach a sample copy)



Do your written contracts contain any of the following: (check all that apply)



Property:

Property Deductible: $250

Contents Limit: $5,000 Bus. Inc. Limit: TBD

Property Deductible: $250

Sprinklered:

Alarm:


General Liability:

General Liability Limits: $1,000,000 / $2,000,000