1. Forms
2. CR
3. CR-DS-04

What the form is

The CR DS 04, titled "Government Crime Policy Declarations," serves as the cover page or declarations for a Government Crime Policy. It is not a standalone coverage form but rather a crucial component that personalizes the policy by outlining the specific choices made by the insured governmental entity. This form details the named insured, policy period, the specific insuring agreements selected, the limits of insurance for each coverage, applicable deductible amounts, and a schedule of any forms and endorsements that apply to and modify the policy. It essentially provides a snapshot of the crime coverage in force for the governmental entity.

Classes of business it applies to

This form is specifically designed for use with governmental entities. Examples of such entities include, but are not limited to:

• Municipalities (cities, towns, villages)
• Counties
• School districts
• State agencies or departments
• Special purpose districts (e.g., water districts, park districts)

Any public entity requiring crime and fidelity coverage would utilize a Government Crime Policy, and the CR DS 04 would be the corresponding declarations page.

Special considerations

Several important considerations apply when using the CR DS 04:

• Accuracy is paramount: All information on the declarations, including the named insured, policy period, limits, and deductibles, must be accurate to ensure the policy responds as intended in the event of a claim.
• Works with a Coverage Form: The CR DS 04 must be attached to a Government Crime Coverage Form, such as the CR 00 25 (Government Crime Coverage - Loss Sustained Form) or CR 00 26 (Government Crime Policy - Discovery Form), to create a complete policy. The declarations specify which coverage form is being used.
• Selection of Insuring Agreements: Governmental entities can choose from various insuring agreements based on their exposures. Common insuring agreements listed on the CR DS 04 include: Employee Theft, Forgery or Alteration, Inside the Premises – Theft of Money and Securities, Inside the Premises – Robbery or Safe Burglary of Other Property, Outside the Premises, Computer Fraud, Funds Transfer Fraud, and Money Orders and Counterfeit Money. Not all insuring agreements may be selected; the declarations will indicate which are active and their respective limits and deductibles.
• Endorsements: The declarations page will list all endorsements attached to the policy. These endorsements can modify coverage, add or exclude provisions, or comply with state-specific requirements.

Key information for agents and underwriters

For agents, the CR DS 04 is a critical document for:

• Confirming that the policy is issued according to the client's requests and needs.
• Explaining the scope of coverage, limits, and deductibles to the governmental entity.
• Identifying any potential coverage gaps based on the selected insuring agreements and limits.

For underwriters, the CR DS 04 provides:

• A summary of the risk being undertaken, including the types and amounts of coverage provided.
• Essential data for rating and premium calculation (though the premium itself might be shown on this form or a separate premium summary).
• A checklist to ensure all necessary forms and endorsements are included in the policy.
• Confirmation of specific choices made by the insured, such as whether coverage is primary or excess.

Careful review of the CR DS 04 is essential for both parties to ensure a clear understanding of the Government Crime Policy in effect.