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"Over the past five years, The O'Neill Group has provided us with a professional service relationship and a unique sense of friendliness and compassion. They've understood the diverse environment of a charter school, in addition to realizing the financial constraints of a newly established entity. The O'Neill Group was not only very responsive in providing for our insurance needs; they offered it at a resonable cost" -Ron King, Business Manager, Eagle Heights Academy, Younstown, OH

Errors and Omissions Quote
Information provided on this form will be kept confidential and shared only with affiliate companies for quoting purposes. We respect your privacy, and we will never sell or share this information with any outside parties.

*Required

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School Name*
Contact Name*
Email Address*
Phone
Fax
Street Address
City
State zip
School in existance since:
Institution Type public private
Number of Board Members
Members are appointed elected
If appointed, by whom?
Board Member Term years
Current Enrollment
Expected Enrollment Next Year
Limit of Liability Desired $250,000 $500,000 $1,000,000
Other
Deductible $1,000 $2,500 $5,000
$10,000
Is coverage desired for all employees, volunteers, and student teachers? yes no
Total Current Budget
Total Current Expected Deficit
Total Accumulated Deficit
Total Amount of Bond Authority
Total Present
Bonds issued, if any
Current Bond Rating
Do students play organized sports? Yes No
If so, which sports
Is Day Care Provided? Yes No
If yes, how many children?
If any deficit, what is being done to eliminate it?
   
Special Education Programs or Facilities for mentally or physically handicapped yes no
If yes, describe
Total Number of Instructors Currently Employed
   
Do you anticipate staff reduction in next 12 months? yes no
   
Total Number of non-instructional employees, past 3 years
   
Has any employee been suspended, demoted, transferred or contract of employment non-renewed past 12 months? yes no
   
If yes, describe
Has any former employee, applicant or person alleged unfair or improper treatment involving employment practices? yes no
 
Has the board established guidelines for suspension, dismissal, or non-renewal of contract of:
Instructors/Supervisors yes no When?
Other Employees yes no When?
Students yes no When?
Are these guidelines in writing? yes no
Is a Uniform Contract for Instructors used? yes no
   
Has the Board adopted a pay scale for personnel providing for renumeration without regard to age, sex, race, or creed?
  yes no
If yes, year established
Has the Board adopted an affirmative action program for employement?
yes no
If yes, year established
Is the organization involved in any disputes regarding integration?
yes no
If yes, explain
 
Has the organization been closed or activities disrupted during the past three years due to teacher strikes or actions?
  yes no
If yes, explain
No Claims which, if insurance has been in force similar to that now proposed, would have fallen within the scope of such insurance has been made or is now pending against any persons proposed for insurance, except as follows (if answer is none, so state):
 
No person proposed for this insurance is cognizant of any act, error or omission which he/she has reason to suppose might afford valid grounds for any future claim such as would fall within the scope of the proposed insurance, except as follows (if answer is none, so state):
 
The organization, its board, and/or its employees have not been involved in or have any knowledge of any pending Federal, State, or Local legal actions or proceedings against the organization, its board members, or employees except as follows (if answer is none, so state):
 
   
Current School Leaders Errors and Omissions or Directors and Officers Liability currently in force:
Company
Policy Expiration
Limit of Liability
Deductible
Premium

 

 

 

 

  
   

The Charter School Insurance Center
A Division of The O'Neill Group
Toll Free Phone 1-800-334-1561
Fax 330-336-5697
111 High Street
Suite 201
Wadsworth, OH 44281
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