Submission Checklist
Quote Release Information

To send a submission please include all the following items and send to nicole.croteau@willis.com or fax to 603-334-3090.

WasteHaulerGuard Supplemental Application - The supplemental application is required with all submissions, and must be signed by the insured.

  • Completed Acord Applications, signed by the insured, including detailed property information to include construction, occupancy, square footage and age.
  • 5 years of recently valued company loss runs (a loss summary is helpful)
  • Details/explanation of losses over $10,000
  • Full description of operations, including those of additional Named Insureds
  • Expiring premiums and target premiums for all lines of coverage
  • Drivers list, including MVR's
  • Complete vehicle identification numbers (VIN)
  • Federal Employer Identification Number (FEIN)
  • Boiler and Machinery application if coverage is desired
  • Narrative, photos and brochure, if available

If you are not yet appointed with Willis of New Hampshire, Inc. please include the following:

  • Completed and signed Brokerage Agreement with the following:
    • Copy of E&O showing a minimum of $1,000,000 limit per occurrence and aggregate
    • Copy of agency resident license
    • Copy of individual producer resident license
    • If your submission is located in a non-resident state a copy of additional licenses are needed


For More Information on the services and products offered by WasteHaulerGuard, contact:

Nicole Croteau
WasteHaulerGuard Insurance Program
Telephone: (603) 334-3084
Fax: (603) 334-3090
Email: nicole.croteau@willis.com


Address:

One New Hampshire Avenue, Suite 200
Portsmouth, NH 03801