FLEX Bind Request

Named Insured*

As it should appear on the policy - legal name of the business/organization - DO NOT use abbreviations- Please use same named insured as when the policy was quoted.

New or Renewal Policy*

New
Renewal

Contact Name*

First

Last

Are you an agent?

Yes
No

Insurance Agent Name Submitting Bind Request

Agency Name

Email (Where do we send coverage documents?)*

All correspondence will be sent to this email. Please use the email used for correspondence on your original quote.
IMPORTANT- INSURANCE AGENTS: If you are submitting this request on behalf of your insured, you MUST use YOUR email address.

Mailing Address*

Street Address

City

State / Province / Region

ZIP / Postal Code

This address is the mailing address for the insured.

Phone*

Please Bind the Following Coverages

Desired Effective Date*

STANDARD COVERAGES*

General Liability & Accident
General Liability Only*
Accident Only

*Important - Please review your quote in order to determine if the carrier requires Accident coverage to be in force in order to purchase General Liability. If this is indicated on your quote, we will bind General Liability & Accident combined, regardless of the option chosen above.

Additional Coverages (The following additional coverages/enhancements were offered along with the General Liability quote. Please indicate if you wish to bind any of these additional coverages/enhancements. Your premium will be calculated based on the options chosen.)

Medical Expenses (Select yes if included on General Liability Quote)*

Yes
No

Increased Aggregate Limit*

Yes
No

OPTIONAL - Increased Aggregate Limit Options*

Option 1- General Aggregate/Products Completed Opperations Limit Increase to $3,000,000.
Option 2- General Aggregate/Products Completed Opperations Limit Increase to $4,000,000.
Option 3- General Aggregate/Products Completed Opperations Limit Increase to $5,000,000.

Please indicate which aggregate limit you wish to purchase.

Hired/Non-Owned Auto Liability Coverage*

Yes
No

ADDITIONAL - Hired/Non-owned Auto Liability Coverage*

Option 1 -$150,000 Hired / Non-owned Auto
Option 2 -$500,000 Hired / Non-owned Auto
Option 3 -$1,000,000 Hired / Non-owned Auto (Additional approval required)

Please indicate the limit of coverage you wish to purchase.

Abuse/Molestation*

Yes
No

Excess Liability Coverage*

Yes
No

Excess Liability Coverage (please indicate which limit you would like to have in addition to your standard General Liability policy)*

$1,000,000 / $1,000,000
$2,000,000 / $2,000,000
$3,000,000 / $3,000,000
$4,000,000 / $4,000,000

Liquor Liability (This coverage is only offered if your initial application indicated an exposure showing the insured is in the business of selling alcohol and we are able to write liquor liability in your state. Otherwise, you would not be provided a quote for this coverage. If you were provided a quote for this coverage, do you wish to bind coverage for liquor liability?)*

Coverage was not offered.
Yes
No

Additional Available Coverages (The following coverages are also available to clients who have purchased a general liability policy from Sadler & Co., however, an additional application must be submitted and a separate quote will be provided for each coverage. Please indicate if you would like for us to provide you with a quote for these additional coverages.)

Equipment / Inland Marine*

Yes
No

Provides coverage for direct loss or damage to your supplies and equipment, furnishings, improvements and betterments, signs and non-structural glass due to fire, theft, vandalism or other covered causes.

If purchasing Equipment/Building/Contents coverage, does your lender require a loss-payee? (If yes, regardless of any information submitted previously, please respond to your binding confirmation email with a complete list of requirements from lender, including any special wording requests. This will allow us to make sure that we have the most up-to-date information for your policy. ITEMS NEEDED: Name of Lender, Complete Mailing Address and Any Special Wording. A copy of the contract may be required by the carrier. Please note, some endorsements or special wording may require an additional charge.)*

Yes
No

Directors & Officers*

Yes
No

Covers your business entity and its directors and officers against certain lawsuits alleging managerial negligence that results in economic damages or the violation of rights of others under state, federal or constitutional law.

Commercial Property*

Yes
No

Covers your business owned buildings and contents against loss due to perils such as fire, wind, theft, vandalism, etc.

Certificates of Insurance/Endorsements

Do your Property Owners or Sponsors require a Certificate of Insurance? (If yes, regardless of any information submitted previously, you will still need to provide the information with this bind request.)*

Yes
No

If yes, please list requirements from property owners or sponsors, including special wording requests. This will allow us to make sure that we have the most up-to-date information for your policy. ITEMS NEEDED: Name of Property Owner/Sponsor, Complete Mailing Address and Any Special Wording. Please note, some endorsements or special wording may require an additional charge.) If additional space is needed for provide the information, please indicate that you are emailing the requirements and simply respond to the bind request confirmation with the additional insured information.*

Is the physical address of the named insured the same as the mailing address?*

Yes
No

If no, does the property owner require the physical location to be listed on the certificate of insurance?*

Yes
No

If yes, please provide the name of the Property Owner that requires the physical location listed, as well as the physical address of your location.*

1099 Employees

Do you have any 1099 Contractors?*

Yes
No

If yes, please list name(s) and address(s) below for each 1099 contractor.*

How Do You Wish to Pay for Coverage?

PLEASE NOTE: Your request to bind coverage is contingent on the appropriate premium payment being received by Sadler & Company. Coverage will go into effect the date the payment is received or the effective date requested, whichever is later. If payment is returned or disputed, the policy will be canceled flat for non-payment and property owners will be notified.

Payment Options*

PAYMENT IN FULL - CHECK (No Fee)
PAYMENT IN FULL - ACH: (You will receive an ACH link within 12-24 business hours via email. Check your spam filter if not received.) (a service fee of 1%, up to a max fee of $5.00)
PAYMENT IN FULL - CREDIT CARD (VISA OR MASTERCARD ONLY): (You will receive a credit card link within 12-24 business hours via email. Check your spam filter if not received.) (a service fee equal to 3.5% of the total amount due)
FINANCING (IF OFFERED) - FINANCE CHARGES WILL APPLY (The Finance Agreement is attached to the quote. This MUST be printed, signed and returned via email or fax in order to bind.)

PAYMENT IN FULL - CHECK SUBMISSION OPTIONS (Please make check payable to Sadler & Company, regardless of the method of submission.)*

EMAIL - After submitting this bind request, please respond to the quote email (sport3@sadlersports.com) with a copy of the check.
FAX - After submitting this bind request, please fax a copy of the check to 803-256-4017 - Attn: Sports Commercial Processing
MAIL - After submitting this bind request, please mail the check to PO Box 5866, Columbia, SC 29250 (If you email or fax a copy of the check DO NOT also mail the check unless specifically asked to do so, otherwise you may get charged twice.)