Forms & Applications
Below are links to specimen policies, applications and supplements categorized by product.
FORMS & APPLICATIONS
- Multimedia
- American Association of Advertising Agencies (4A's)
- National Association of Broadcasters (NAB)
- Film & Entertainment
New Business Applications
- Multimedia Liability Insurance Application, AXIS 101 0900
- American Association of Advertising Agencies Insurance Application, AXIS 101 0902
- National Association of Broadcasters Insurance Application, AXIS 101 0903
- WriteInsure™ Multimedia Liability Application (Authors Guild), AXIS 101 0953
Renewal Applications
- Multimedia Liability Insurance Renewal Application, AXIS 101 0949
- National Association of Broadcasters Insurance Renewal Application, AXIS 101 0951
- Film & Entertainment Liability Renewal Application - A&D, Distribution and Library, AXIS 1010 0950
Supplements/Questionnaires
Cyber
- Data Security and Privacy Supplemental Application, AXIS 101 0946
- Business Interruption & Data Restoration Supplemental Application, AXIS 101 0947
- Business Interruption & Data Restoration – System Failure Supplemental Application, AXIS 101 0947A
Technology Services
Product Sheets
Product Applications
Admitted
MPL Solutions Application
MPL Solutions Renewal Application
Non-Admitted
Miscellaneous Professional Liability Application
Miscellaneous Professional Liability Renewal Application
Miscellaneous Professional Liability-TechNet Solutions Errors & Omissions Renewal Application
State-Specific
Massachusetts Application Cover Page
MPL Solutions Application (Maine, Texas, Washington)
MPL Solutions Renewal Application (Maine, Texas, Washington)
MPL Solutions Application (New Hampshire)
MPL Solutions Renewal Application (New Hampshire)
MPL Solutions Application (Florida)
MPL Solutions Renewal Application (Florida)
Specimen Policies
Admitted
MPL Solutions Insurance Policy MPL
Non-Admitted
Miscellaneous Professional Liability Insurance Policy
Supplements
Admitted
MPL Solutions - Association Management Company Supplement
MPL Solutions - Claims Adjuster Supplement
MPL Solutions - Computer Technology Supplement
MPL Solutions - Educational Seminar Instructor Supplement
MPL Solutions - Employment Agency-Executive Search Supplement
MPL Solutions - Freight Forwarders-Customs Brokers Supplement
MPL Solutions - Graphic Designer Supplement
MPL Solutions - Interior Design-Decoration Supplement
MPL Solutions - Management Consulting Supplement
MPL Solutions - Mid-Term Acquisition, Merger or Newly Created Entity Questionnaire
MPL Solutions - Mid-Term Change of Name Due to Acquisition or Merger Questionnaire
MPL Solutions - Mortgage Brokers-Mortgage Bankers Supplement
MPL Solutions - Network Security Supplement
MPL Solutions - Notary Public Supplement
MPL Solutions - Online Internet Related Services Supplement
MPL Solutions - Premium Finance Company Supplement
MPL Solutions - Printers Supplement
MPL Solutions - Public Record Search Supplement
MPL Solutions - Public Relations-Promotion-Marketing Firms Supplement
MPL Solutions - Real Estate Operations Supplement
MPL Solutions - RESPA Questionnaire
MPL Solutions - Standards Organizations Supplement
MPL Solutions - Third Party Administrators-Review Boards Supplement
MPL Solutions - Travel Agency-Tour Operator Supplement
MPL Solutions - User-Generated Content Supplement
Non-Admitted
Association Management Company Supplement
Claims Adjuster Supplement
Clinical Labs-Testing Labs Supplement
Computer Technology Supplement
Educational Seminar Instructor Supplement
Employment Agency-Executive Search Supplement
Freight Forwarders-Customs Brokers Supplement
Graphic Designer Supplement
Interior Design-Decoration Supplement
Management Consulting Supplement
Mid-Term Acquisition-Merger-Newly Created Entity Questionnaire
Mid-Term Change of Name Due to Acquisition-Merger Questionnaire
Mortgage Brokers-Mortgage Bankers Supplement
Notary Public Supplement
Online Internet Related Services Supplement
Premium Finance Company Supplement
Printers Supplement
Public Record Search Supplement
Public Relations-Promotion-Marketing Firms Supplement
Real Estate Operations Supplement
RESPA Questionnaire
Standards Organizations Supplement
Third Party Administrators-Review Boards Supplement
Travel Agency-Tour Operator Supplement
Product Applications
Non-Admitted
Specimen Policies
Non-Admitted
Product Applications
Admitted
PrivaSure™ Breach Response Insurance Application
PrivaSure™ Breach Response Insurance Renewal Application
Non-Admitted
PrivaSure™ Breach Response Insurance Application
PrivaSure™ Breach Response Insurance Renewal Application
State-Specific
Massachusetts Application Cover Page
PrivaSure™ Breach Response Insurance Application (Florida)
PrivaSure™ Breach Response Insurance Application (Georgia)
PrivaSure™ Breach Response Insurance Application (Montana)
PrivaSure™ Breach Response Insurance Application (New Hampshire)
PrivaSure™ Breach Response Insurance Application (West Virginia)
PrivaSure™ Breach Response Insurance Renewal Application (Florida)
PrivaSure™ Breach Response Renewal Application (Georgia)
PrivaSure™ Breach Response Insurance Renewal Application (Montana)
PrivaSure™ Breach Response Insurance Renewal Application (New Hampshire)
PrivaSure™ Breach Response Insurance Renewal Application (West Virginia)
Specimen Policies
Admitted
PrivaSure™ Breach Response Insurance Policy
Non-Admitted
Product Applications
Admitted
TechNet Solutions™ Application
TechNet Solutions™ Mid-Term Acquisition Application
TechNet Solutions™ Renewal Application
Non-Admitted
TechNet Solutions™ Application
TechNet Solutions™ Mid-Term Acquisition Application
TechNet Solutions™ Renewal Application
State-Specific
Massachusetts Application Cover Page
TechNet Solutions™ Application (Arkansas)
TechNet Solutions™ Mid-Term Acquisition Application (Arkansas)
TechNet Solutions™ Renewal Application (Arkansas)
TechNet Solutions™ Application (GA, ME, NC & WV)
TechNet Solutions™ Mid-Term Acquisition Application (GA, ME, NC & WV)
TechNet Solutions™ Renewal Application (GA, ME, NC & WV)
TechNet Solutions™ Application (Kansas)
TechNet Solutions™ Mid-Term Acquisition Application (Kansas)
TechNet Solutions™ Renewal Application (Kansas)
TechNet Solutions™ Application (Montana)
TechNet Solutions™ Mid-Term Acquisition Application (Montana)
TechNet Solutions™ Renewal Application (Montana)
TechNet Solutions™ Application (New Hampshire)
TechNet Solutions™ Mid-Term Acquisition Application (New Hampshire)
TechNet Solutions™ Renewal Application (New Hampshire)
Specimen Policies
Admitted
TechNet Solutions™ Insurance Policy
Non-Admitted
American Association of Advertising Agencies (4A) - Product Applications
Admitted
New York Free Trade Zone
Advertising Agency Liability Application
Non-Admitted (AK, LA, OK and PR - VT and WY for Defense within Limits coverage)
State-Specific
Massachusetts Application Cover Page
4A Application (Florida)
American Association of Advertising Agencies (4A) - Specimen Policies
Admitted
4A Multimedia Liability Policy - Claim Expense Within the Limit
4A Multimedia Liability Policy - Claim Expense Outside the Limit
New York Free Trade Zone
Advertising Agency Liability Policy - Claim Expense Within the Limit
Advertising Agency Liability Policy - Claim Expense Outside the Limit
Non-Admitted (AK, LA, OK and PR - VT and WY for Defense within Limits coverage)
4A Multimedia Liability Policy - Claim Expense Within the Limit
4A Multimedia Liability Policy - Claim Expense Outside the Limit
American Society of Association Executives (ASAE) - Product Applications
Non-Admitted
ASAE Application
ASAE Renewal Application
American Society of Association Executives (ASAE) -Specimen Policies
Non-Admitted
American Society of Association Executives (ASAE) - Supplements
Non-Admitted
Affiliate Organization Supplement
Certification-Accreditation Supplement
Consulting Services Supplement
Subsidiary Organizations Supplement
Technology Services Supplement
National Association of Broadcasters (NAB) - Product Applications
Admitted
NAB Application
NAB Data and Privacy Protection Coverage Application
New York Free Trade Zone
Broadcasters Liability Application
Broadcasters Liability Cyberliability Supplement
Broadcasters Liability Data and Privacy Protection Coverage Application
Non-Admitted (LA, OK and PR - VT and WY for Defense within Limits coverage)
NAB Application
NAB Data and Privacy Protection Coverage Application
State-Specific
Massachusetts Application Cover Page
North Carolina Application Cover Page
NAB Application (Florida)
NAB Application (Montana)
NAB Application (New Hampshire)
NAB Data and Privacy Protection Coverage Application (Florida)
National Association of Broadcasters (NAB) - Specimen Policies
Admitted
NAB Specimen Policy - Claim Expense Outside the Limit
NAB Specimen Policy - Claim Expense Within the Limit
New York Free Trade Zone
NAB Specimen Policy - Claim Expense Outside the Limit
NAB Specimen Policy - Claim Expense Within the Limit
Non-Admitted (LA, OK and PR - VT and WY for Defense within Limits coverage)
NAB Specimen Policy - Claim Expense Outside the Limit
NAB Specimen Policy - Claim Expense Within the Limit
National Association of Broadcasters (NAB) - Supplements
Admitted
New York Free Trade Zone
Non-Admitted (LA, OK and PR - VT and WY for Defense within Limits coverage)
State-Specific
Cyberliability Supplement (Florida)
Cyberliability Supplement (Montana)
Cyberliability Supplement (New Hampshire)
National Association of Television and Program Executives (NATPE) - Product Applications
Admitted
NATPE Acquisition & Development, Distributor, and Film Library Liability Application
NATPE Producer Liability Application
State-Specific
NATPE Acquisition & Development, Distributor, and Film Library Liability Application (New Hampshire)
NATPE Producer Liability Application (New Hampshire)