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You must be an appointed agent with Markel to submit an application.
For more information about appointments, click here.
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In addition to an ACORD application, please complete the appropriate applications:
Hospital Fleet Complete Application
Email your completed applications to firstname.lastname@example.org or fax to 678-290-2200.
In addition to the application(s), we need the following:
- Acord Forms (125 & 127 at minimal)
- 3-5 years of currently valued hard copy carrier loss runs
- Driver schedule to include full driver name, driver's license number, driver's license state, date of birth, and date of hire
- Include MVRs, if available
- Vehicle schedule to include: year, make, ambulance manufacturer, type (I, II, or III), original cost new, current value, and lienholder information (for example - 2003 Ford AEV, Type II OCN, $72,000/ACV, $28,000, no lien). For all other vehicles, list as normal.
Medical Transportation Brochure
Cheryl Hahn, Underwriting Manager
Dan Young, Underwriter