|
Program Applications
Click on the link below to download your selected application (Microsoft Word Required):
Public Entity Application Applicant Information
(required on any and all public entity risks in addition to the Acord applications)
Public Entity Application General Liability
(required on any and all public entity risks in addition to the Acord applications)
Public Entity Supplemental Questionnaires:
A - Streets/Roads/Highways/Bridges
B - Special Events
C - Day Care
D - Landfill/Dump/Refuse Site/Incinerator
E - Sewer/Water Utility
F - Electric Utility
G - Gas Utility
K - Recreational Activities
M - Dams and Reservoirs
N - Port/Transportation/Airport Authorities
P - Miscellaneous Exposure
Q - Convention/Civic Center Exposure
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
Public Entity Application Law Enforcement Liability
School Supplemental Application
Required on any and all public or private school risks located outside New York State in addition to the ACORD applications.
New York School Supplemental Application
Required on any and all public or private school risks located in New York State in addition to the ACORD applications.
The following Questionnaires are applicable to all states and are to be completed in addition to the School Supplemental Application if the exposure exists:
Educators Legal Liability Applications
CA, CO, CT, DE, ID, IL, IN, KS, MA, MI, MN, MS, MO, NJ, OK, PA, SD, VT, WY:
AL, AZ, AR, DC, FL, GA, IA, KY, MD, ME, MT, NC, ND, NE, NH, NM, NV, OH, OR, RI, SC,
TN,TX, UT, VA, WA, and WI:
All states except New York:
New York:
Environmental Impairment Liability Applications - All States:
Student Accident - All States:
Network Security & Privacy - New York:
School Violent Acts - New York:
| 
