Clone of ACCO-SIG 2026/2027 Law Enforcement Member Underwriting Application

1

If your entity needs templates for policies click the link below.

If your entity should have any questions or need assistance in completing the application please contact Dusty Birdsong.

Direct Line - (405) 516-5318 Cellphone - (405) 802-9647

2

Jail Trust* This field is required.

3

Do you have a written Jail Policy and Procedures Manual?* This field is required.

YESNO

4

Is the County Jail Policy distributed to all county jail personnel?* This field is required.

YESNO

5

Has the County Jail Policy been signed by all county jail personnel?* This field is required.

YESNO

6

Is periodic training provided for all jail personnel?* This field is required.

YESNO

7

Does your jail have an onsite licensed medical professional?* This field is required.

YESNO

8

Does your jail use Turn Key Health Services?* This field is required.

YESNO

9

Does your jail have a written Use of Force Policy?* This field is required.

YESNO

10

You have selected "NO" to having a written Use of Force Policy in place. By not submitting your Use of Force Policy you understand that you are subject to a premium adjustment.* This field is required.

Yes

11

Submit your jail's Use of Force Policy

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Max. file size: 10.6MB

12

Have all jail personnel signed and acknowledged they have read and understood your jail's Use of Force Policy?* This field is required.

YESNO

13

Does your jail have a written Intake of Inmate Policy?* This field is required.

YESNO

14

You have selected "NO" to having a written Intake of Inmate Policy in place. By not submitting your Intake of Inmate Policy you understand that you are subject to a premium adjustment.* This field is required.

Yes

15

Submit your jail's Intake of Inmate Policy* This field is required.

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Max. file size: 10.6MB

16

Have all jail personnel signed and acknowledged they have read and understood your jail's Intake of Inmate Policy?* This field is required.

YESNO

17

Does your jail have a written Inmate Medical Care Policy?* This field is required.

YESNO

18

You have selected "NO" to having a written Inmate Medical Care Policy in place. By not submitting your Inmate Medical Care Policy you understand that you are subject to a premium adjustment.* This field is required.

Yes

19

Submit your jail's Inmate Medical Care Policy* This field is required.

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Max. file size: 10.6MB

20

Have all jail personnel signed and acknowledged they have read and understood your jail's Inmate Medical Care Policy?* This field is required.

YESNO

21

Does your jail have a written Sexual Misconduct Policy?* This field is required.

YESNO

22

You have selected "NO" to having a written Sexual Misconduct Policy in place. By not submitting your Sexual Misconduct Policy you understand that you are subject to a premium adjustment.* This field is required.

Yes

23

Submit your jail's Sexual Misconduct Policy* This field is required.

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Max. file size: 10.6MB

24

Have all jail personnel signed and acknowledged they have read and understood your jail's Sexual Misconduct Policy?* This field is required.

YESNO

25

Does your jail have a written Suicide Detection and Prevention Policy?* This field is required.

YESNO

26

You have selected "NO" to having a written Suicide Detection and Prevention Policy in place. By not submitting your Suicide Detection and Prevention Policy you understand that you are subject to a premium adjustment.* This field is required.

Yes

27

Submit your jail's Suicide Detection and Prevention Policy* This field is required.

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Max. file size: 10.6MB

28

Have all jail personnel signed and acknowledged they have read and understood your jail's Suicide Detection and Prevention Policy?* This field is required.

YESNO

29

Form Completed by* This field is required.

First Name

Last Name

30

Submitter's Phone Number* This field is required.

Please enter a valid phone number.

31

Submitter's Email* This field is required.

example@example.com