I am an Active or House Counsel Member of the Idaho State Bar; and
I DO NOT represent private clients and am not required to carry professional liability insurance; or
I represent private clients and am currently covered by professional liability insurance.
The name of my primary insurance carrier is:
#mojoInput( "insurance" $insurance "carrierName" )
Attorneys selecting this option must submit proof of current professional liability insurance coverage at the minimum limit of $100,000 per occurrence/$300,000 annual aggregate. Proof may be in the form of a certification from your insurer that includes the name of the carrier, name of the insured(s), term and policy limits. If you submit the Declaration page from your policy to prove compliance with this rule, please redact any information not required by this rule, including the premium amount. Please email your proof of coverage to firstname.lastname@example.org
I am an Active or House Counsel Member whose practice of law is limited to practicing within an employment setting exclusively for an employer and its commonly owned organizational affiliates and my employer is not in the business of providing legal services. My employer maintains insurance coverage that is the equivalent of that required by I.B.C.R. 302(a)(5) that covers my practice of law.
The name of my employer is:
#mojoInput( "insurance" $insurance "employerName" )
Attorneys selecting this option do not need to submit proof of insurance coverage.
I will notify the Idaho State Bar in writing within 30 days if any professional liability insurance policy providing coverage lapses, is no longer in effect, or terminates for any reason, unless the policy is renewed or replaced without substantial interruption.
#mojoInput( "insurance" $insurance "confirmation" ) I am $!esc.html( $ren.member.name.format() ) and I certify the information provided in the above Disclosure of Professional Liability Insurance is complete and correct.
Note: For purposes of the Uniform Electronic Transactions Act (Idaho Code Title 28, Chapter 50), checking the box above constitutes an electronic signature.