Application for Firm Quote and Proposal

A firm quote will be issued with a completed Novus 8 page application and the following information:

1) CV
2) Copy of declarations page or Certificate of Insurance.
3) Claims history past 10 years and insurance company reports verifying claims history.
5) Copy of bariatric program description and consent forms for bariatric surgery.

• Novus Application for Firm Quote and Proposal

Novus Insurance Company
1000 Adams Avenue
Trooper, PA 19403

or fax documents to (610) 537-4883

Any questions, please call Cindy Del Priore @ (800) 220-2929, ext. 12488
or Mike Wolfe at ext. 12440.

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