PRIOR POLICY
Provide the policy number, carrier, limits and the inception and expiration dates of any policy that provided employee dishonesty coverage for the applicant over the last five years.
|
Policy
number
|
Carrier
|
Employee
dishonesty limit
|
Inception date
|
Expiration date
|
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Note: This information is needed when a loss is discovered in the current policy year for an occurrence in prior years
EMPLOYEES
Does the applicant employ any person who has committed a theft or dishonest act? ___ Yes ___ No
Note: These employees are excluded from coverage and should not be included for rating purposes.
Are all potential employees screened prior to employment? ___ Yes ___ No
Are references required and verified? ___ Yes ___ No
Does applicant contract with another firm to lease employees? ___ Yes ___ No
Does applicant lease employees without using an outside agency? ___ Yes ___ No
Does applicant use volunteers? ___ Yes ___ No
Note: Temporary leased employees who are substituting for regular employees are covered; others, including volunteers,
are excluded and should not be included for rating purposes.
MANAGEMENT CONTROLS
Does a person outside of the applicant's accounts payable unit verify the accuracy
of all monthly paid invoices? ___ Yes ___ No
Are invoices stamped "paid" at the time checks are issued to prevent duplicate checks
from being issued to fictitious persons? ___ Yes ___ No
Are auditor-suggested improvements in internal controls implemented? ___ Yes ___ No
Is there adequate separation of duties between employees who:
Receive money and keep books? ___ Yes ___ No
Disperse money and keep books? ___ Yes ___ No
Reconcile bank accounts and deposit or withdraw? ___ Yes ___ No
