Contractors professional liability app

    • [DOC File]APPLICATION FOR SPECIFIED MEDICAL PROFESSIONS …

      https://info.5y1.org/contractors-professional-liability-app_1_39b381.html

      APPLICATION FOR SPECIFIED MEDICAL PROFESSIONS FOR PROFESSIONAL LIABILITY INSURANCE (Claims Made Basis) APPLICANT’S INSTRUCTIONS: 1. Answer all questions. If the answer requires detail, please attach a separate sheet. 2. Application must be signed and dated by owner, partner or officer. 3. Please do not complete application earlier than 45 days before proposed …

      professional liability for contractors

    • [DOCX File]Contractors Supplemental Application

      https://info.5y1.org/contractors-professional-liability-app_1_e9d3d9.html

      Pollution or Professional Liability, separate information will be required. APPLICANT INFORMATION: * Complete the table . on page . 5. if . There Are . multiple named insureds * First Named Insured (if multiple named insureds – see page 5) Date Business was established: Eff Date: Quote Due Date Target. Premium (This helps us determine service needs) $ Describe nature of construction ...

      contractors professional liability insurance application

    • [DOC File]Contractors LP App Template - Hull and Co

      https://info.5y1.org/contractors-professional-liability-app_1_9f81a1.html

      Professional Liability, Faulty Workmanship, Defective Products Liability and/or Pollution Liability Claim Information 22. Have any claims been made or legal action been brought in the past ten years (or made earlier and still pending) against your company, its predecessor(s) or any past or present principal, partner, officer, director, shareholder or employee? If yes, provide the following ...

      contractors professional application

    • [DOC File]GENERAL CONTRACTORS/DEVELOPERS GENERAL …

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      If yes, has Professional Liability Coverage been obtained? Yes No. Limit of Liability: $ 33. Does applicant hold other persons’ property for service, storage or repair? Yes No . If yes, explain: 34. Any underground storage tanks? Yes No. If yes, when inspected and by whom? 35. Any employees working under: U.S. Longshoremen’s and Harborworkers’ Act? Yes No. Jones Maritime Act? Yes No. If ...

      consultants professional liability application

    • Contractors LP App Template

      Associated Builders & Contractors, Inc. (ABC) 17. Please provide the following information for your current policies: (Applicants must carry General Liability and Umbrella Liability Limits equal to or greater than the Professional Liability or Errors/Omission limits being requested.) Particulars. General Liability. Umbrella Liability. a.Insurer

      contractors professional liability insurance

    • [DOC File]Application For Oil & Gas Service Contractors

      https://info.5y1.org/contractors-professional-liability-app_1_905642.html

      Professional Liability: _____ General Liability (each occurrence): _____ General Liability (aggregate): _____ ... Application For Oil & Gas Service Contractors Author: Armel Désir Description: As per Cole (1-5-04) this form is no longer in use. Last modified by: GWOODS Created Date: 1/13/2009 7:03:00 PM Company : General Star Management Other titles: Application For Oil & Gas Service ...

      contractors e&o app

    • [DOC File]Alarm Contractors Supplemental Application

      https://info.5y1.org/contractors-professional-liability-app_1_4bdedf.html

      Yes No If yes, please explain: Have you or any director, officer, employer or partner ever been subject to disciplinary action as a result of professional services? Yes No If yes, please attach an explanation. Has the applicant reported any Professional Liability Claims in the past 5 years? Yes No If yes, please explain: If you provide design work for others without performing work please name ...

      construction professional liability

    • Contractors LP App Template

      Professional Liability and/or Pollution Liability Claim Information 46. Have any claims been made or legal action been brought in the past ten years (or made earlier and still pending) against your firm, its predecessor(s) or any past or present principal, partner, officer, director, shareholder or employee? If yes, provide the following information for each claim on a separate sheet: Y N A ...

      contractor professional liability application

    • [DOC File]INSURANCE PROFESSIONALS ERRORS & OMISSIONS

      https://info.5y1.org/contractors-professional-liability-app_1_ee7f29.html

      insurance professionals errors & omissions and related professional liability insurance application. this is an application for insurance written on a “claims made and reported” basis which applies only to claims first made while the policy is in force. 1. name of applicant: _____

      professional liability for contractors

    • [DOC File]APPLICATION FOR ACUPUNCTURISTS PROFESSIONAL …

      https://info.5y1.org/contractors-professional-liability-app_1_62203c.html

      Independent Contractors d. Ratios of professional staff to occupied beds by shift: 1st_____:_____ 2nd _____:_____ 3rd _____:_____ e. Annual employee turnover rate: RNs LPNs CNAs 6. CLAIMS/HISTORY. If “Yes” to any of the questions below, attach a detailed explanation. a. Have you been the subject of investigatory or disciplinary proceedings or reprimand by an . administrative or ...

      contractors professional liability insurance application

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