Technology Errors & Omissions Liability Renewal-FAILSAFE MEGA®

Contact Information

("Applicant", "you", "yours" and "your" include any person or entity for whom this insurance is intended):

Coverage Information

Please note that additional underwriting information (i.e. copy of a typical customer contract signed by the applicant or financials) may be requested based on the information provided within this application including limit requests of $2M / $2M or greater.
Please provide the following information on the applicant's customers & contracts:
I, being duly authorized, have read the above application and declare to the best of my knowledge and belief all of the foregoing statements are true, and that these statements are offered as an inducement to the Company to issue the policy for which I am applying. (Kansas: This does not constitute a warranty).

First State Insurance Company (N/A in MA) New England Reinsurance Corporation (N/A in MA)
Hartford Accident and Indemnity Company Nutmeg Insurance Company (N/A in MA)
Hartford Casualty Insurance Company Omni Indemnity Company (N/A in MA)
Hartford Fire Insurance Company Omni Insurance Company (N/A in MA)
Hartford Insurance Company of Illinois (N/A in MA) Pacific Insurance Company, Limited (N/A in MA)
Hartford Insurance Company of the Midwest Property and Casualty Insurance Company of Hartford
Hartford Insurance Company of the Southeast (N/A in MA) Sentinel Insurance Company, Ltd.
Hartford Lloyd's Insurance Company (N/A in MA) Trumbull Insurance Company (N/A in MA)
Hartford Underwriters Insurance Company Twin City Fire Insurance Company
New England Insurance Company (N/A in MA)