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PAGE 1 OF 4StaffPak is a division of Innovation Growth Partners Specialty, LLC | Rev. 12.15.25 Renewal Application 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254 DOCUMENTATION

PAGE 1 OF 11StaffPak is a division of Innovation Growth Partners Specialty, LLC | Rev. 12.17.25 Staffing and PEO Insurance Application 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254

Stop Gap Questionnaire 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254 StaffPak is a division of Innovation Growth Partners Specialty, LLC | Rev. 11.20.25 Applicant/Named Insured:

Third-Party Crime Questionnaire 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254 StaffPak is a division of Innovation Growth Partners Specialty, LLC | Rev. 11.20.25 Applicant/Named

1 WORKERS’ COMPENSATION - Temporary Staffing Supplemental Application Applicant Name:________________________________________________________________________________________ Applicant Primary

EVENT CANCELLATION & NON-APPEARANCE APPLICATION BROKER INFORMATION Broker/Agency Name: Contact Person: Phone #: E-Mail: GENERAL APPLICANT INFORMATION Name of Insured: Name of Applicant (if

EVENT CANCELLATION & NON-APPEARANCE APPLICATION BROKER INFORMATION Broker/Agency Name: Contact Person: Phone #: E-Mail: GENERAL APPLICANT INFORMATION Name of Insured: Name of Applicant (if

SpecialEvents@Take1insurance.com SPECIAL EVENTS APPLICATION 1. Name of Applicant Federal Employer I.D. No. 2. Address Street City County State ZIP Code 3. Event Dates: From

WEATHER INSURANCE APPLICATION BROKER INFORMATION Broker/Agency Name: Address: City: State: Zip: Contact Person: Phone #: E-Mail: GENERAL APPLICANT INFORMATION Name of Insured: Insured Street

Wind/Hail Deductible Buyback Application 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254 TCAP (Tailored Community Association Plan) is a Division of Innovation Growth Partners Specialty,

Architects & engineers Insurance application form US The purpose of this application form is for us to find out more about you. You must provide us with all information which may be material to

HiscoxPRO™ Accountants Professional Liability application form WCLMPL A0004 CW (06/16)

WCLANE A0003 CW (09/20) 1 Contractors Professional Liability Application NEW BUSINESS APPLICATION Applicant Information Name of Applicant (attach a separate

STARSTONE SPECIALTY INSURANCE COMPANY APPLICATION LAWYERS PROFESSIONAL LIABILITY INSURANCE APPLICATION FOR CLAIMS-MADE AND REPORTED PROFESSIONAL LIABILITY INSURANCE POLICY, LIMITED TO ONLY

PF-18868b (06/16) © 2016 Page 1 of 8 ACE American Insurance Company Illinois Union Insurance Company Westchester Fire Insurance Company Westchester Surplus Lines Insurance Company

A-TMC-10010 (10-21) © 2021 CapSpecialty, Inc. All rights reserved. Page 1 of 7 CAPITOL INDEMNITY CORPORATION CAPITOL SPECIALTY INSURANCE CORPORATION | A Stock Company P. O. Box 5900 | Madison,

EAPP 351 03 21 Copyright, Everest Reinsurance Company, 2021 Page 1 of 6 Veterinarian Professional Liability Multi-State Insurance Application This application is intended for use in all states

EAPP 351 03 21 Copyright, Everest Reinsurance Company, 2021 Page 1 of 6 Missouri Veterinarian Professional Liability Insurance Application This application is intended for use in MISSOURI only.

Veterinary & Animal Services Renewal Summary Application RENEWAL EFFECTIVE/EXPIRATION DATES: From To 12:01 A.M., Standard Time, at the address of the Applicant Legal Name and DBA/AKA (include

Veterinary and Animal Services Application (2018/10)  Version 1  Business Auto Insurance Supplement: Important: Please provide a copy of your current policy Declaration Page listing the Named