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Proof of Coverage Request
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Visit AHRP
File a Claim / Incident
Auto Accident Claims / Incidents
All Other Claims / Incidents
Policy Requests / Changes
Certificates of Insurance
Proof of Coverage Request
Property Coverage Change
Automotive Liability Change
Bare Land Coverage Change
Underwriting Questionnaire
Visit AHRP
Visit ARHP
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For Public Housing Authorities
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Loss Control Grant Application Request
Contact
HARRP
HARRP Overview
Why Pooling?
Our Leadership (HARRP)
Our Board
Our Members
Request for Public Records
Employment Opportunities
Coverages
For Public Housing Authorities
HARRP Coverage Agreement
Resources
Training
Fair Housing
Safety & Loss Control
Templates
Consulting Services
Insurance Requirements in Contracts
Vehicle and Driving
Archived Newsletters
Loss Control Grant Application Request
Contact
Auto Liability Coverage Change
Change Auto Liability Coverage
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Housing Authority or Insured Entity
*
Your name
*
First
Last
Your email
*
Your phone
*
Vehicle Description
Vehicle make
*
Vehicle model
*
Vehicle year
*
Vehicle color
*
Vehicle Identification Number (VIN)
*
Inventory #
Are you adding or deleting this vehicle from coverage?
*
Add Vehicle
Delete Vehicle
Effective Date
*
MM slash DD slash YYYY
Is this a passenger van?
*
YES
NO
If ADDING to coverage, add LIABILITY and/or PHYSICAL DAMAGE?
*
If not adding either, skip question.
ADD Liability Coverage
ADD Physical Damage Coverage
Add medical coverage (non-employee passengers)?
*
Medical coverage should be selected if a non-employee(s) is being transported in the vehicle who would not be covered under your Worker's Comp policy in the event of an injury; additional premium applies.
YES, add medical coverage
NO, do not add medical coverage
Add personal use coverage?
*
Personal coverage should be selected if the vehicle is being used freely for both personal and business use at any/all hours at the discretion of the employee (typically reserved for executive directors); additional premium applies.
YES, add personal use coverage
NO, do not add personal use coverage
Vehicle Purchase Price
*
ELECTRONIC SIGNATURE
*
I certify that the information on the application is true and accurate to the best of my knowledge. I understand that if alternate information becomes available, it may result in a change of premium or policy/coverage cancellation. By submitting I am providing my electronic signature.
Have questions, or need help right away?
(360) 574-9384
Rachel O’Neil
can answer your questions related to Auto Proof of Coverage requests