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

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

CLICK HERE FOR TEMPLATE POLICIES

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
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County* This field is required.
Please Select
Please Select
ADAIR
ALFALFA
ATOKA
BEAVER
BECKHAM
BLAINE
BRYAN
CADDO
CANADIAN
CARTER
CHEROKEE
CHOCTAW
CIMARRON
CLEVELAND
COAL
COMANCHE
COTTON
CRAIG
CREEK
CUSTER
DELAWARE
DEWEY
ELLIS
GARFIELD
GARVIN
GRADY
GRANT
GREER
HARMON
HARPER
HASKELL
HUGHES
JACKSON
JEFFERSON
JOHNSTON
KAY
KINGFISHER
KIOWA
LATIMER
LEFLORE
LINCOLN
LOGAN
LOVE
MAJOR
MARSHALL
MAYES
McCLAIN
McCURTAIN
MCINTOSH
MURRAY
MUSKOGEE
NOBLE
NOWATA
OKFUSKEE
OKLAHOMA
OKMULGEE
OSAGE
OTTAWA
PAWNEE
PAYNE
PITTSBURG
PONTOTOC
POTTAWATOMIE
PUSHMATAHA
ROGER MILLS
ROGERS
SEMINOLE
SEQUOYAH
STEPHENS
TEXAS
TILLMAN
TULSA
WAGONER
WASHINGTON
WASHITA
WOODS
WOODWARD
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Does Your Entity Have an Adopted Personnel Policy?* This field is required.
YESNO
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You have selected "NO" to having a written Personnel Policy in place. By not submitting your Personnel Policy you understand that you are subject to a premium adjustment.* This field is required.
Yes
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Submit Personnel Policy* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Have all employees signed and acknowledged they have read and understood the personnel policy?* This field is required.
YESNO
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Does Your Entity Have an Drug Testing Policy?* This field is required.
YESNO
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You have selected "NO" to having a written Drug Testing Policy in place. By not submitting your Adopted Personnel Policy you understand that you are subject to a premium adjustment.* This field is required.
Yes
9
File Submit Drug Testing Policy* This field is required.
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Select files to upload
Max. file size: 10.6MB
Cancelof
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Have all employees signed and acknowledged they have read and understood the drug testing policy?
YESNO
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Does Your Entity Have an Adopted Safety Policy?* This field is required.
YESNO
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You have selected "NO" to having a written Safety Policy in place. By not submitting your Safety Policy you understand that you are subject to a premium adjustment.* This field is required.
Yes
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Submit Safety Policy* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Have all employees signed and acknowledged they have read and understood the safety policy?
YESNO
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Form Completed by
First Name
Last Name
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Submitter's Phone Number
Please enter a valid phone number.
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Submitter's Email
example@example.com
Should be Empty: