FOOD MANUFACTURERS & DISTRIBUTORS — PRODUCTS LIABILITY INSURANCE INTAKE FORM

FOOD PRODUCTS LIABILITY INSURANCE APPLICATION INSTRUCTIONS

Follow steps 1-4 below. Complete the application as thoroughly as possible, save the PDF, then return to this page to upload the application and supporting documents securely.

TO BE USED WITH: All types of food & beverage manufacturers, processors, co-packers, distributors, importers, and white label & private label operations — including packaged foods, snacks, baked goods, sauces & condiments, beverages, frozen & refrigerated products, and all other FOOD PRODUCTS where PRODUCT LIABILITY coverage is needed or required.

Important Form Notice: This intake process is intended for food & beverage manufacturers, processors, blenders, co-packers, bottlers, packagers, importers, distributors, and white/private-label sellers — including packaged and prepared foods, snacks, baked goods, confectionery, sauces, condiments, spices, beverages, dairy, frozen and refrigerated products, and related food items. The application may be used for review of Products Liability, Products-Completed Operations, and related coverage needs.

Complete As Much As Possible: Please fill out as much of the application as you can before uploading. The more detail you provide about your products and operations, the faster underwriters can review your submission.

Complete, Save & Upload the Products Liability Application

Before uploading, also review Step 2 and Step 3 below and complete those items if they apply to your business. Once you have everything ready — the completed application and any supporting documents — head down to Step 4 to upload your saved PDF(s).

First, complete the Products Liability Application. It will open in a new browser tab so you can return here after saving it.

After completing the application, save the completed PDF to your computer. Then return to this page and upload it in Step 4.

Important: No signatures are required on this application for quoting purposes. Please complete the application as thoroughly as possible, save it, and upload it in Step 4. Signatures may be requested later by an insurance carrier if coverage is offered and you decide to proceed.

Click Here First Open Products Liability Application ➡

Product Links If your products are sold online, copy and paste a few product page links directly into the application (or its Remarks section). This gives our team a clear picture of the types of food items you manufacture, distribute, or sell.

Have Ready To Upload Gather any ingredient lists, nutrition and label information, brochures, specifications, and quality-control or food-safety protocols. Keep these handy so you can return to this page and upload them in Step 4.

Remarks Section The last page of the application includes a Remarks section. Use it to clarify any answers and to add other information about your operations, products, or manufacturing that helps describe your business.

Complete Fully Complete as much of the application as possible before uploading. Thorough, accurate answers help underwriters review faster and may lead to more competitive terms.

No Signature No signature is needed for quoting. Signatures may be requested later only if coverage proceeds.

No Loss Statement

If the business has never experienced any claims, or if this is for a new business, complete a No Loss Statement.

Once submitted, it will automatically notify the Kelly Insurance Group team.

No Claims? Complete No Loss Statement ➡

Current Loss Runs

If you currently have insurance coverage, we will need copies of your current carrier loss runs.

Use the button to review how to request loss runs and copy the email wording below.

Loss Run Instructions

Loss runs are a statistical history of your claim history. Most underwriters require this information, even if you have had zero losses.

If loss runs are not available online through your carrier portal, send a request to your current carrier, agent, or broker.

Hi __________, We are currently reviewing our insurance program and would like copies of our claims history, also known as Loss Runs, for our internal review. Please provide this information for all lines we have on file with your company. We are looking for our five-year Loss Run history. Thanks for your help and your quick attention to this matter.

Email wording copied.

Upload Application & Supporting Documents

After completing and saving the Products Liability Application, upload it below. You may also upload product links, ingredient lists, label and nutrition information, brochures, specifications, quality-control or food-safety protocols, loss runs, current policy documents, or other supporting information.

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Disclaimer: Coverage availability and eligibility may depend on underwriting review, carrier guidelines, policy terms, state requirements, business operations, risk characteristics, and other information provided during the application or quoting process. Kelly Insurance Group cannot guarantee that every individual, customer, organization, or business seeking coverage will qualify for, receive, or successfully place insurance coverage. All policy coverages, exclusions, conditions, limits, endorsements, and terms should be carefully reviewed by the consumer, insured, or applicant to confirm that the coverage requested is the coverage being quoted, offered, or provided. Insurance coverage, policy changes, endorsements, cancellations, and other policy terms are not bound, changed, confirmed, or altered unless and until written confirmation is provided by a licensed Kelly Insurance Group team member, the applicable insurance carrier, or an authorized underwriter. This page is provided for general informational purposes only and does not provide legal advice, legal opinions, insurance coverage opinions, or policy interpretations.