Forms

Auto Forms

The prompt reporting of the sale or disposal of a vehicle ensures that you will receive full and proper credit for any premium refund.

The prompt reporting of auto accidents enables not only the quick repair and return of your vehicle, but it also enables the ORM to effectively investigate the accident and properly manage any claims or litigation that may arise. Experience has shown that immediate investigation and contact with injured parties greatly reduces the long-term costs of the processing and settlement of such claims.

Auto Liability Certificate of Insurance Request

Add or Remove Vehicle Form

Auto Accident Report Form

Springfield Auto Packet

Building Forms

You can add or delete a building or request builder’s risk insurance quickly and easily by filling out one of our online forms.

Add Building Form

Builder’s Risk Insurance Request

Remove Building from Program and Insurance Coverage

Claims Forms

One of our objectives is to provide protection, support, and guidance to our locations in the event of losses, whether they are first-party property losses or third-party liability losses. One way that we meet this obligation is by assisting locations in resolving claims quickly and in the most cost-effective manner possible. It is imperative that a claim be reported as soon as possible. The more time passes, the more difficult it is to conduct the investigation and manage the claim.

Accident Report (online form); Accident Report (PDF form)

Claimant Incident Report (online); Claimant Incident Report (PDF form)

Witness Report (online form); Witness Report (PDF form)

Property Claim (online form); Property Claim (PDF form)

General Liability Accident Forms

We care about the safety and well-being of all our program participants and those you serve. When an accident occurs, it is imperative that the accident be reported as soon as possible.

Accident Report (online form); Accident Report (PDF form)

Claimant Incident Report (online); Claimant Incident Report (PDF form)

Witness Report (online form); Witness Report (PDF form)

Host Liquor Liability Form

This form is used when you would like to purchase liquor liability coverage for Parish-sponsored events or diocesan organization events.

Host Liquor Liability Request

Special Event Insurance

If you rent out your parish hall, whether for meetings or events, renters must obtain Special Event Insurance. This includes receptions held after funerals, and all non-parish sponsored group meetings. Special Event Insurance is a protection for the parish and the Diocese in the event of an accident. Please contact Ashly Patry to purchase Special Event Insurance, or fill out the following form and fax/email it to Ashly:

Special Event Insurance Form Facilities Usage Indemnity Agreement

 

Field Trip Forms

When planning field trips and outings, we ask that you take the necessary precautions to ensure the safety and security of all participants and staff.

Youth Activity Participation Form Adult Activity Participation Form Use of Personal Vehicle for School Activities Emergency Action Plan

Helpful Resources

Field Trip Checklist

Taking Care of Children with Allergies

Top 10 Traveler Tips

 

 

Property Forms

Property claims management focuses on identifying the cause of property damage or loss, mitigating further damage, taking measures to repair the damage and returning the location back to normal operations as quickly as possible.

Scheduled Property Coverage

Property Claim (online form)

Springfield Property Claim Report Fillable 2021 (PDF form)

Worker's Comp

For workers’ compensation forms, please see: www.masscatholic.org