Forms
FDIP Eligibility Application
This form is used to apply, change, remove, or reapply for coverage to participate in the Fire Department Insurance Program. Coverage begins when SRM approves the application. The review may include a physical inspection of the property, vehicles, and related records.
FDIP Building Coverage
This form is uses to report any additions, deletions, or changes to building and/or contents covered by the property program. Make sure all items on form are complete.
FDIP Auto Physical Damage (APD) Coverage
This form is used to add, delete, or change a vehicle or vehicle equipment coverage listed under the APD program. When adding a vehicle, include proof of ownership.
FDIP Auto Liability Coverage
This form is used to report any additions, deletions, or changes to vehicles listed under the liability program.
FDIP Team Members List
This form is used to add or delete Team Members. Team Members include members, officials, board members, dispatchers or volunteers of the organization acting in good faith within the duties or tasks lawfully assigned by the authority of the Fire Chief or other competent authority.
FDIP Property or Vehicle Loss
This form is used to report damage to the fire department’s property or vehicle in the event of a loss. A deductible will apply to this type of loss.
FDIP Incident Form (Tri-fold)
Keep the incident form with incident card in glovebox of all fire department vehicles. Review instructions to complete all steps. Submit incident form to SRM.
FDIP Standard Liability Incident Report (SLIR) Employment
This form is used to describe what happened during the accident. There are different SLIR’s for different incident types: Vehicle & Other Property, Personal/Bodily Injury, and Employment Incidents.
FDIP Standard Liability Incident Report (SLIR) Vehicle & Other Property
This form is used to describe what happened during the accident. There are different SLIR’s for different incident types: Vehicle & Other Property, Personal/Bodily Injury, and Employment Incidents.
FDIP Standard Liability Incident Report (SLIR) Bodily Injury
This form is used to describe what happened during the accident. There are different SLIR’s for different incident types: Vehicle & Other Property, Personal/Bodily Injury, and Employment Incidents.
FDIP Scope Of Employment (SOE)
This form is used to describe what job duty was being performed by the fire member at the time of the incident.
FDIP Incident Card
Keep the incident card with the FDIP incident form in the glovebox of all fire department vehicles. Give the card to the other driver in case of an incident so they can contact SRM with questions on how to file a claim.
