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Fire Protection Public Fire Dept.: Paid or Volunteer ______________________ Distance from yard _______________ No. of public fire hydrants_____ Distance from yard ___ Private Fire Protection (describe in full) ___________________ ________________________ Watchman Service: Is service provided? (Yes (No How many 24 Hours per day: (Yes [...]

EMPLOYEES’ COMPENSATION INSURANCE PREMIUM ADJUSTMENT & DECLARATION OF ACTUAL EARNINGS FORM 僱員補償保險僱員補償保險僱員補償保險僱員補償保險 ---- 保費調整及保費調整及保費調整及保費調整及僱員實際僱員實際僱員實際僱員實際收入申報表收入申報表收入申報表收入申報表 (Form A - Declaration of Actual Earnings during the expired period 申報表申報表申報表申報表 A - 去年實際收入) Insured 受保人: Policy No.保單編號: Period of Insurance保險期限: Occupations of Employees Note (1) [...]

NAV APL CL SUPP (07 11) Page 1 of 2 NAVIGATORS INSURANCE COMPANY ACCOUNTANTS PROFESSIONAL LIABILITY SUPPLEMENT 10 – CLAIMS SUPPLEMENT Applicant: Please complete one supplement for each claim, lawsuit, incident, disciplinary action, or grievance. Attach additional sheets for descriptions as necessary. 1. Name of Individual from the firm involved in [...]

NAV APL PS SUPP (07 11) Page 1 of 1 NAVIGATORS INSURANCE COMPANY ACCOUNTANTS PROFESSIONAL LIABILITY SUPPLEMENT 1 – PROFESSIONAL STAFF SUPPLEMENT Applicant: ____________________ NAME DESIGNATION IF PART-TIME, ANNUAL HOURS WORK FOR APPLICANT FIRM DATE OF HIRE (MM/DD/YY) YEARS IN PRACTICE PROFESSIONAL DESIGNATIONS AND LICENSES 1 [...]

NAV APL NIC PF (07 11) Page 1 of 13 NAVIGATORS INSURANCE COMPANY A “Stock” Company Home Office: One Penn Plaza, New York, NY 10119 THIS IS A CLAIMS MADE AND REPORTED POLICY. CLAIM EXPENSES ARE WITHIN AND REDUCE THE LIMIT OF LIABILITY. PLEASE READ THE ENTIRE POLICY CAREFULLY. ACCOUNTANTS PROFESSIONAL LIABILITY POLICY Words and phrases that appear in bold print [...]

FI 00 H015 01 0309 © 2009, The Hartford Page 1 of 7 __________________________________________________________________________ Name of Insurance Company to which application is made APPLICATION FOR A FINANCIAL INSTITUTION BOND FOR INVESTMENT FIRMS Application is hereby made by _____________________________________________________________________________________________ (List all [...]

International General Liability Your Underwriting Team These talented underwriters are a part of the growing International Casualty team, made up of General Liability, Environmental and Life Sciences. 2 44 (0) 20 7220 3993 tom.smith@thehartford.com Tom leads the General Liability team with over 20 years of experience in the industry and is acknowledged as a leader within the [...]

Premier Defense, our new market-leading Directors & Officers (D&O) Liability policy is designed to address demand for innovative solutions for the complex litigation and regulatory issues faced by publicly traded companies and their directors and officers. We combine our leading product offering with financial strength, international capabilities, a seasoned underwriting staff [...]

Time is precious for busy agents. That’s why we designed our innovative portal, The Hartford Pronto. It helps you protect your clients by making it easy to submit, quote and sell management liability coverages. THE HARTFORD PRONTO MAKES QUOTING A CINCH FOR YOU AND YOUR CLIENTS The streamlined application form is available in The Hartford Pronto. • Answer only the questions relevant to [...]

PF 00 H002 00 0121 © 2021, The Hartford Page 1 of 2 THE HARTFORD PREMIER DEFENSE FIDUCIARY LIABILITY POLICYSM DECLARATIONS ____________________________, A stock insurance company, herein called the Insurer Policy Number: ______________ NOTICE: THIS POLICY PROVIDES CLAIMS MADE AND REPORTED COVERAGE. EXCEPT AS OTHERWISE SPECIFIED HEREIN, COVERAGE APPLIES ONLY TO CLAIMS [...]