Sports Commercial Bind Request Thank you for choosing Sadler Sports & Recreation Insurance for your insurance needs! In order to bind coverage, please complete the following information and select the payment option you wish to use. 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. Contact Name* First Last If Applicable, Insurance Agent Name Submitting Bind Request Email* 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 Phone* Please Bind the Following Coverages Desired Effective Date* MM slash DD slash YYYY 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. OPTIONAL COVERAGES (Please select which Optional policies you wish to purchase.)* Increased Aggregate Limit Hired/Non-owned Auto Liability Coverage Abuse / Molestation Sublimit Excess Liability Coverage Liquor Liability Equipment/Inland Marine (Additional Application Required) Property (Additional Application Required) Directors & Officers Liability (Additional Application Required) DECLINE OPTIONAL COVERAGES - I do not wish to purchase any optionals at this time. 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. OPTIONAL - 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) Excess Liability Coverage* $1,000,000 / $1,000,000 $2,000,000 / $2,000,000 $3,000,000 / $3,000,000 $4,000,000 / $4,000,000 Do your Property Owners or Sponsors require a Certificate of Insurance? (If yes, regardless of any information submitted previously, please respond to your binding confirmation email with a complete list of requirements from property owners or sponsors, 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 Property Owner/Sponsor, Complete Mailing Address and Any Special Wording. Please note, some endorsements or special wording may require an additional charge.)* Yes No 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 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 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.) FINANCING (ONLY IF PREMIUM IS OVER $1,000) - 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.)