Municipal Entity Applications

For your convenience, all application forms are available below. Please complete the required form and forward it to your designated HARIE office. (Adobe® Reader required. Download times are calculated for a 56k modem connection.)

Government Entities App Acord 125
(591kb; Approx. 1 min. 30 sec.)

Property, Inland Marine, & Crime Acord 140
(1.06Mb; Approx. 2 min. 30 sec.)

Auto Insurance Acord 127
(1.25Mb; Approx. 3 min.)

General Liability Acord 126-S
(2.0Mb; Approx. 5 min. 30 sec.)

Worker’s Compensation Acord 130
(678kb; Approx. 1 min. 30 sec.)

Fidelity Acord
(636kb; Approx. 1 min. 30 sec.)

For more information on HARIE, e-mail us today or call (570) 344-1152.