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Submit Applications Online!
Or Email Application to apps@abraminterstate.com
Or fax the completed form to 916.780.7181
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| For your convenience you can download
applications with Adobe Acrobat Reader®.
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Accounting
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| Check by Fax Form- [Microsoft Word] |
| Agency Sweep Authorization - [Adobe] |
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Equine Mortality
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| Markel Hassle Free Mortality and Theft Application - [Adobe] |
| Markel Justification of Value -[editable, Adobe] - Please complete this form when required. |
| Standard Theft and Mortality -[Adobe] |
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Farm
/ Ranch
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| Travelers Farm/Ranch - [editable, Adobe]- Please complete this form for property and liability coverage for working horse, cattle and crop farms. |
| Travelers Equine Liability Application - [editable, Adobe] - Please complete this application for any risk with owned or non-owned horses. |
| Travelers CCC -[editable, Adobe] - Optional endorsement when there are non-owned horses. |
| Travelers Agribusiness Supplemental - [editable, Adobe] - This form can be used to supplement an ACORD Application. |
| Great American Equine Farm -[editable, Adobe] - Complete this application for property & liability for horse farms. |
| Great American Equine Liability Application - [editable, Adobe] - Complete this application for commercial equine liability coverage. If the applicant owns the property, please complete the Great American Equine Farm application (above.) |
| Great American CCC - [editable, Adobe] - Coverage is only applicable for non-owned horses. Please complete this form in addition to the Equine Farm or Equine Liability application if coverage is desired. |
| Great American Individual Horse Owner Liability - [editable, Adobe] - Coverage for personal horses only. No commercial operations can be present. |
| Markel Private Horse Owner - [editable, Adobe] - Please complete this application if there are no commercial operations. Additional Insureds are not permitted on this policy. |
| Great American Race Horse Owners Liability - [editable, Adobe] - Coverage for horses used for racing or race training |
| Woodburning Stove Questionnaire - [editable, Adobe] |
| Markel Commercial Equine Liability - [editable, Adobe] |
| Markel Riding Instruction Supplement - [editable, Adobe] - Complete with the Markel Commercial Equine Liability application if there is any riding instruction exposure |
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Commercial Lines
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| Commercial Property and Casualty Quick Quote - [editable, Adobe]Indication ONLY |
| ACORD Commercial Applications -[editable, Adobe] |
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ACORD 125 Commercial Insurance Application |
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ACORD 126 Commercial General Liability Section |
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ACORD 140 Property Section |
| ACORD 175 Commercial Policy Change Request - [editable, Adobe] |
| Special Event Liability Application - The Main Event - [Adobe] |
| ACORD 131 Umbrella Application - [editable, Adobe] |
| Employment Practices Liability Application - [editable, Adobe] |
| ACORD 130 Workers Compensation Application - [editable, Adobe] |
| Workers Compensation Supplemental Application - [editable, Adobe] |
| ACORD 28 Evidence of Commercial Property Insurance - [editable, Adobe] |
| ACORD 25 Certificate of Liability Insurance - [editable, Adobe] |
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Personal Lines Return to Top
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| ACORD Homeowner Application - [editable, Adobe] |
| ACORD Dwelling Fire Application -[editable, Adobe] |
| ACORD 1 Property Loss Notice -[editable, Adobe] |
| ACORD 67CA Residential Property Insurance Disclosure - [editable, Adobe] |
| ACORD 70 Personal Policy Change Request (Except Auto) -[editable, Adobe] |
| ACORD 66CA Offer of Earthquake -[editable, Adobe] |
| ACORD 81 Personal Inland Marine -[editable, Adobe] |
| ACORD 83 Personal Umbrella Application - [editable, Adobe] |
| Homeowner's Questionnaire -[editable, Adobe] |
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| Lloyds |
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Binding Instructions |
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| Lloyds Supplemental Corporate - [editable, Adobe] |
| Supplemental Heating Questionnaire - [editable, Adobe] |
| ACORD 85 Mobile Home Application -[editable, Adobe] |
| Lloyds Homeowner Guidelines -[Adobe] |
| Lloyds Dwelling Fire Guidelines -[Adobe] |
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| Safeco |
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| Safeco Supplemental Questionnaire - [editable, Adobe] - This form can be used to supplement an ACORD Application. |
| Safeco Home & Dwelling Fire Underwriting Guidelines -[Adobe] |
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| Travelers |
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Binding Instructions |
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| Travelers Home and Dwelling Fire Supplement - [editable, Adobe] |
| Travelers Homeowners Endorsements -[Adobe] |
| Travelers Homeowners Guidelines-[Adobe] |
| Travelers Homeowners Quick Qualifier - [editable, Adobe] |
| Travelers Alternate Heating Questionnaire - [editable, Adobe] |
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| TOPA |
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Binding Instructions |
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| TOPA Homeowners Application - [Adobe] |
| TOPA Dwelling Fire Application - [Adobe] |
| TOPA ACORD Supplemental Application - [editable, Adobe] |
| TOPA Replacement Cost and Earthquake Disclosures - [editable, Adobe] |
| TOPA Home EQ Rates -[Adobe] |
| TOPA Fire Dwelling EQ Rates -[Adobe] |
| TOPA Water Disclosure Form - [editable, Adobe] |
| TOPA Race Gender Form - [editable, Adobe] |
| TOPA Homeowners Guidelines-[Adobe] |
| TOPA Dwelling Fire Guidelines.-[Adobe] |
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Auto
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| TRAVELERS- Preferred |
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Quoting Instructions |
Binding Instructions |
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| ACORD California Personal Auto Application - [editable, Adobe] |
| ACORD CA Auto Supplement (Uninsured Motorist Reduction/Waiver) - [editable, Adobe] |
| Travelers Named Driver Exclusion - [editable, Adobe] |
| Good Student/Driver Training - [editable, Adobe] |
| Travelers EFT Enrollment Form - [Adobe] |
| Travelers Accident and Comprehensive Loss Detail Form - [editable, Adobe] |
| ACORD Personal Auto Policy Change Request - [editable, Adobe] |
| Travelers Auto Guidelines -[ Adobe] |
| Privacy Policy Notice - [Adobe] |
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| FIC – UNITRIN SPECIALTY – Non-Standard Programs |
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Quoting Instructions |
Binding Instructions |
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| Uninsured Motorist Rejection/Reduction Form - [Adobe] |
| Named Driver Exclusion - [Adobe] |
| Additional Equipment Form - [Adobe] |
| Credit Card Authorization Form - [Adobe] |
| Automatic Withdrawal/EFT Authorization - [Adobe] |
| Domestic Partnership Affidavit - [Adobe] |
| FIC-Unitrin Auto Guidelines -[Adobe] |
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| SAFECO- Preferred & Standard Programs |
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Quoting Instructions |
Binding Instructions |
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| ACORD California Personal Auto Application - [editable, Adobe] |
| Safeco Supplement to ACORD Application - [Adobe] |
| Safeco Uninsured Motorist Reduction/Waiver - [ Adobe] |
| Safeco Driver Exclusion - [ Adobe] |
| ACORD Good Student/Driver Training - [editable, Adobe] |
| ACORD Personal Auto Policy Change Request - [editable, Adobe] |
| Safeco Privacy Notification - [Adobe] |
| Safeco Choicepoint Important Notice - [Adobe] |
| Safeco Mandatory Coverage Offer - [Adobe] |
| Safeco Auto Guidelines -[Adobe] |
| Safeco Automatic Deduction Authorization - [Adobe] |
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| Commerce West Insurance – Preferred Auto, Non-standard, and Nation Safe Driver Programs |
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Quote & Bind directly with this carrier!! Click on the link below to complete an application for direct access through Abram Interstate: |
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Quoting Instructions |
Binding Instructions |
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| Commerce West Application for Appointment |
| Uninsured Motorist Rejection/Reduction Form - [Adobe] |
| Named Driver Exclusion - [Adobe] |
| Business Use Exclusion - [Adobe] |
| EFT Authorization Form - [Adobe] |
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Miscellaneous Return to Top
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| Arizona SL-2 - [Adobe] |
| SL-2 - [editable, Adobe] |
| SL-2 Instructions -[Adobe] |
| D-1 Form - [Adobe] |
| Agent/Broker of Record Change - [editable, Adobe] |
| California Department of Insurance Race, National Origin & Gender Form - [editable, Adobe] |
| Cancellation Request/Policy Release - [editable, Adobe] |
| Evidence of Insurance - [editable, Adobe] |
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