CompWestInsurance.com
1-800-CompWest
CompWest Insurance Company is a member of AF Group. Insurance policies may be issued by any of the following companies within AF Group:
Accident Fund Insurance Company of America, Accident Fund National Insurance Company, Accident Fund General Insurance Company, United Wisconsin Insurance Company, Third Coast Insurance Company or CompWest Insurance Company.
Safety Program Library Procedures Agreement
CompWest Insurance Company is pleased to provide you with access to National Resource Safety Center’s video library. We have a contractual
arrangement with NRSC that enables us to provide their safety programs to you on loan. You’re permitted to borrow up to three programs per
month. You may reserve programs by email at losscontroldept@compwestinsurance.com or by faxing this form to 844-293-6934. Programs can
be reserved up to 90 days in advance. Since shipping time must be considered, as well as the actual time that the programs may be in your
possession, we limit the number of programs reserved to two at any given time. In order to use this library, you must agree to the conditions
outlined below.
1.) SHIPPING: Safety programs are on loan with NO RENTAL FEES for a 21-day period. The 21-day period commences the day the programs are
shipped. Programs ordered must be placed at least seven days in advance of your requested delivery date and will be shipped to the borrower at
no cost. Borrower will be responsible for the return shipping. Borrower agrees to use a carrier for the return shipping that can provide proof of
delivery.
2.) GRACE PERIOD: You will be allowed a return grace period of up to 10 calendar days beyond the due date of your order. After the grace period
expires, the program(s) will be considered lost and the borrower will be billed to replace the program(s) (not to exceed $200 per lost program).
There is a $50 restocking fee for programs returned after grace period.
3.) LOST OR DAMAGED PROGRAMS: Borrowers are liable for programs that are not returned or damaged (other than damages caused by
shipping). We recommend that you carefully inspect all programs when they are first received. If a program is determined to be damaged,
CompWest must be notified immediately. Borrowers are liable for programs not returned on or before the due date and grace period. Any
programs not returned (other than being lost in the mail) will be billed for their replacement.
4.) RESTRICTIONS: Programs may not be shown where an admission is charged. NOTE: Federal law provides severe civil and criminal penalties for
unauthorized reproduction, distribution or exhibition of copyrighted motion pictures. (Title 17, United States Code, Section 501 and 506).
5.) DISCLAIMER: While the Information contained In the programs provided by National Resource Safety Center is believed to be reliable and
correct, National Resource Safety Center makes no warranty, expressed or implied, with respect to the use of any Information, method, process
disclosed; or that such use may not infringe upon privately owned rights; and does not assume any liability or responsibilities, expressed or implied
with respect to the use of any information, method, or process disclosed in these programs or the accuracy of the information herein.
Safety Video Request Information
***ALL VIDEO REQUESTS REQUIRE A MINIMUM OF 7-10 DAYS ADVANCE NOTICE BEFORE REQUESTED DATE***
Borrower’s Name: Email:
Company Name: Phone:
Shipping Address: City: State: Zip Code:
(Must Be A Physical Address. Not A P.O. Box)
Policy Number:
I agree to the terms and conditions outlined above.
Authorized Signature: Date:
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signature
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