Americas Leading Insurer of Emergency Organizations

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Insurance applications for fire departments, ambulance and rescue squads and 911 centersWe look forward to working with you!

Find applications and forms below that your underwriter may request you complete in order to obtain the most competitive terms for your clients. Return completed applications to your Regional Director or

Glatfelter Insurance Group will be making a transition to electronic delivery of all policies, endorsements and invoices for all business placed with GHP, GPP and Non-Regional Director VFIS. Any accounts written through GSB, GRP, New York Safety Groups 491, 497 or 90 and VFIS Regional Director states will NOT be available electronically.

Contact Client Services at: with questions or to update your agency’s contacts.

VFIS Applications

Name Link Date
2016 A&S Only Application View Download 09/22/2016
Building Valuation View Download 07/13/2016
Scheduled Portable Equipment Addendum View Download 05/10/2016
Vehicle Descriptions for Portable Equipment coverage View Download 03/09/2016
Vehicle Schedule for Large Fleets View Download 02/02/2016
VFIS Supplement to ACORD Application View Download 01/13/2016
2017 P&C Addendum for Large Property Schedules View Download 02/20/2017
2018 P&C Application (with Accident & Sickness) View Download 04/25/2018
New York Cancer Coverage View Download 05/04/2018

Benefits Applications

Name Link Date
Critical Illness Request for Proposal View Download 08/04/2016
Group Term Application View Download 07/08/2016
LOSAP Defined Benefit Application View Download 06/03/2016
LOSAP Defined Contribution Application View Download 05/05/2016
Special Risk Application View Download 04/05/2016
Beneficiary Designation Form View Download 09/22/2016