Zurich's Group Personal Accident Insurance includes coverage options for Accident Medical Expense; Accidental Death and Dismemberment or Catastrophic Injury. Please use the checklist below to indicate the operation in the QBE Pacific Islands region to which you will be submitting your proposal. MARKET.1. YOU must answer all questions giving full and complete answers. 2. It is YOUR duty to provide all information that is requested in the Proposal Form. Listing of all TDI forms. Claim No. Date of Loss. INSTRUCTIONS: Proposers must submit ten paper copies of their proposals, including the. Fill out and return to the Harris County Purchasing Department ONE (1) complete proposal form in an appropriately sized envelope or box. TxDOT collects crash reports from Texas law enforcement agencies for crashes occurring on public roadways and the state highway system.