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SUPPLEMENTAL APPLICATION SWAP MEET If so, do you require the vendors to name you as an additional insured on their insurance? Yes No Please provide a copy of insurance

SUPPLEMENTAL APPLICATION TRUCK TRACTOR PULL PRG 142070 (12-22) ©All rights reserved. Page 1 of 2 NAME : ________________________________________________________________________________________

MOTORSPORTS OFF-TRACK AND STORAGE QUESTIONNAIRE PRG 142071 (12-22) ©All rights reserved. Page 1 of 6 Effective Date of Coverage: I. APPLICANT INFORMATION Full Name of Insured as it is to

RACING OWNERS & SPONSORS LIABILITY QUESTIONNAIRE PRG 142076 (12-22) ©All rights reserved. Page 1 of 1 APPLICANT INFORMATION Racing Team Racing Sponsor Insured Name Doing Business As:

RACE TEAM SUPPLEMENTAL QUESTIONNAIRE Use in conjunction with ACORD General Liability & Auto Applications PRG 142074 (12-22) ©All rights reserved. Page 1 of 1 Under the named insured on your

MOTORSPORTS SANCTIONING BODY INSURANCE QUESTIONNAIRE PRG 142075 (12-22) ©All rights reserved. Page 1 of 2 1. APPLICANT INFORMATION Legal Name: Doing Business As: Mailing Address: City: State

EVENT PROMOTER Application For Motorsports Insurance PRG 142140 (01-23) ©All rights reserved. Page 1 of 6 GENERAL INFORMATION E-Mail Address: Website Address:

March 14,2021 COMMUNICABLE DISEASE EXPOSURE AND INFECTION ASSUMPTION OF RISK, HOLD HARMLESS, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT ________________________________ FILL IN TRACK

SAFEHOLD SPECIAL RISK, INC. COMPLETE ALL SECTIONS PROMOTER TRACK SANCTIONING BODY / PROMOTER NHRA  TRACK PROMOTED  WDRA  IMCA  IHRA 

FatherMotherGuardian: Textfield-0: FatherMotherGuardian-0: Printed Name of MINOR Participant: DOB: Address of Participant: Printed Name of Parent or Guardian 1: Printed Name of

Name of Track andor Event: Event Dates: Textfield-0: Textfield-1: Textfield-2: Textfield-3: Textfield-4: Textfield-5: Textfield-6: Textfield-7: Textfield-8: Textfield-9:

CONTACT US Bob Allen Account Executive and Producer Safehold Motorsports Program O: (704) 901-8639 | C: (507) 327-8416 bob.allen@igpspecialty.com Visit us at igpspecialty.com Speed,

Facility Insurance Application Facility Name I Facility Age Contact Person I Title Facility Location Phone I Fax I Email Annual Admissions I Seating I Total Capacity I Total Gross Receipts

HEALTH CLUB FACILITY SUPPLEMENTAL GENERAL LIABILITY APPLICATION (Separate application required for each location) Effective Date: Date of Application: -------------------- ---------------

Skating Facility Inflatables Supplemental Application Separate application required for each location I. General Information Named Insured I DBA Facility Address Website I Email II.

Supplemental Sports Facility Questionnaire Separate application required for each location I. General Information Named Insured DBA Facility Address Website Email Is the applicant: Is the

CONTACT US Dallas: (800) 232-5830 Kerrisa Woodard Professional Liability Division (423) 983-7131 kerrisa.woodard@usrisk.com igpspecialty.com A Accreditation Organizations Actuaries Adjusters

Wholesale Professional & Executive Liability ©2026 INNOVATION GROWTH PARTNERS SPECIALTY, LLC REV 03.12.26 igpspecialty.com Your Wholesale Solution for Hard-to-Place Insurance Agency E&O IGP

GENERAL COVERAGE FEATURES ■ Available limits $2M/$4M per claim/ annual aggregate ■ Full prior acts available ■ Defense outside available ■ Duty to defend ■ 80/20 hammer/settlement clause ■

PROFESSIONAL LIABILITY ■ Defense outside limit option available ■ Personal injury included when related to professional services ■ Contingent BI/PD coverage available ■ Claims Made and