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APPENDIX C <br /> CITY OF ELK RIVER/Elk River Municipal Utility <br /> AGENT OF RECORD RFP RESPONSE FORM <br /> INSURANCE COMPANY INFORMATION <br /> Commercial Property/Casualty (list your top 5 companies by premium volume written and indicate the dollars of <br /> premium written): <br /> Branch: National: <br /> What is your Annual Premium Volume by Coverage Area? Branch National <br /> Property/Boiler Machinery <br /> General Liability <br /> Auto Liability <br /> Public Officials/E&O <br /> Crime <br /> Workers Compensation <br /> Professional Liability <br /> Names of governmental entities insured by the agency through the LMCIT during the last five years. For each <br /> client reference, include the scope of the service, time performed, and name,title, address and phone number of <br /> the principal contact person. <br /> C-5 <br />