Professional Underwriters Program Applications
Click on the link below to download your selected application (Microsoft Word Required): 

County / Municipal / Utility Application
(required on any and all public entity risks in addition to the Acord applications)

Supplemental Building Application
(for each building valued over 1 million, at the underwriter’s discretion)

Public Officials Liability Application

Employment Practices Liability Application

Employment Practices Liability Application  - NY

Supplemental Downsizing / Layoff Information Form 

Environmental Impairment Application

Following applications are NOT APPLICABLE TO New York State.  Please refer to the Applications for New York State section below.

School and College Supplemental Application
(required on any and all public or private school risks in addition to the accord applications)

Supplemental Application for Camps
(to be completed in addition to the School and College Supplemental Application if there is a camp operation in place)

Day Care / Preschool Supplemental Application
(to be completed in addition to the School and College Supplemental Application if there is a day care or preschool operation in place)

Armed Security Guard Questionnaire
(to be completed in addition to the School and College Supplemental Application if insured utilizes armed security personnel)

Rifle Range Questionnaire
(to be completed in addition to the School and College Supplemental Application if exposure exists)

Project Adventure Questionnaire
(to be completed in addition to the School and College Supplemental Application if exposure exists)

Supplemental Building Application
(to be completed for any building valued over 1 Million, at underwriter’s discretion)

Private Schools Supplemental Application
(to be completed in addition to the School and College Application if risk is a private school)

Educators Legal Liability Application 

Environmental Impairment Application

Supplemental Claims Information Form

Supplemental Downsizing / Layoff Information Form

Student Accident Insurance Application

Student Accident Claim Form

Applications for New York State - Textbook Insurance Program

New York School and College Supplemental Application
(required on any and all public or private school risks in addition to the accord applications)

New York Supplemental Application for Camps
( to be completed in addition to the School and College Supplemental Application if there is a camp operation in place)

New York Day Care / Preschool Supplemental Application
(to be completed in addition to the School and College Supplemental Application if there is a day care or preschool operation in place)

New York Armed Security Guard Questionnaire
(to be completed in addition to the School and College Supplemental Application if insured utilizes armed security personnel)

New York Rifle Range Questionnaire
(to be completed in addition to the School and College Supplemental Application if exposure exists)

New York Project Adventure Questionnaire
(to be completed in addition to the School and College Supplemental Application if exposure exists)

New York Environmental Impairment Application

New York School Leaders Errors and Omissions Application

New York Network Security Insurance Application

New York Student Accident Insurance Application

New York Student Accident Claim Form

SafetyFirst Supplemental Application

General Application

Public Officials Liability Application

Employment Practices Liability (Claims Made) Application

Law Enforcement Liability Application

Claims Made Educators' Legal and Employment Practices Liability Insurance Application

Claims Made Educators' Legal and Employment Practices Liability Insurance Renewal Application