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PRODUCER NAME: CS REPRESENTATIVE NAME: OFFICE PHONE(A/C, No, Ext): AGENCY CUSTOMER ID: CODE: SUB CODE: ADDRESS: E-MAIL FAX(A/C, No): MOBILE PHONE: AGENCY NAME AND ADDRESS ASSOCIATION OTHER: "

ACORD 131.pdf

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/acord/acord-131.pdf?v=17b991dc

5/16/2025 8:00:02 PM

TM DAMAGE TO RENTED PREMISES DATE (MM/DD/YYYY) PHONEAGENCY APPLICANT(A/C, No, Ext): (FirstFAX Named(A/C, No): Insured) EFFECTIVE DATE EXPIRATION DATE PAYMENT PLAN AUDIT FOR COMPANY USE ONLYCODE

Artisan Contractors Supplemental Application.doc

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/apps-page-only/commercial/artisan-contractors-supplemental-application.doc?v=b868da3a

4/19/2021 3:28:22 PM

Scottsdale Insurance Company Home Office: One Nationwide Plaza Columbus, Ohio 43215 Adm. Office: 8877 North Gainey Center Drive Scottsdale, Arizona 85258 Scottsdale Indemnity Company Home

Habitational Liability Application.doc

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/apps-page-only/commercial/habitational-liability-application.doc?v=bd0361ce

4/19/2021 3:28:22 PM

Scottsdale Insurance Company Home Office: One Nationwide Plaza Columbus, Ohio 43215 Adm. Office: 8877 North Gainey Center Drive Scottsdale, Arizona 85258 Scottsdale Indemnity Company Home

Welding General Liability Supplemental Application.doc

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/apps-page-only/commercial/welding-general-liability-supplemental-application.doc?v=c13bb36b

4/19/2021 3:28:22 PM

- Scottsdale Insurance Company Home Office: One Nationwide Plaza Columbus, Ohio 43215 Adm. Office: 8877 North Gainey Center Drive Scottsdale, Arizona 85258 Scottsdale Indemnity Company Home

U.S. Risk Call Center-Answering Service E&O Application.pdf

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/apps-page-only/professional/u.s.-risk-call-center-answering-service-eo-application2.pdf?v=c2c48b47

5/12/2022 8:26:51 PM

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U.S. Risk Cyber Security and Privacy Questionnaire.pdf

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/apps-page-only/professional/u.s.-risk-cyber-security-and-privacy-questionnaire.pdf?v=c326c13e

5/13/2022 6:54:57 PM

JVBERi0xLjcNJeLjz9MNCjQ1OCAwIG9iag08PC9MaW5lYXJpemVkIDEvTCA1NTIyNzAvTyA0NjEvRSAyMjU3MTgvTiAzL1QgNTUxNjc4L0ggWyAxNTI0IDE0MTddPj4NZW5kb2JqDSAgICAgICAgICAgIA02ODggMCBvYmoNPDwvRGVjb2RlUGFybXM8PC9Db2x1bW5z

U.S. Risk Insurance Agents Application Including Group Benefit Supplement.pdf

https://www.igpspecialty.com/siteassets/documents/forms-and-applications/apps-page-only/professional/u.s.-risk-insurance-agents-application-including-group-benefit-supplement.pdf?v=c44d6323

4/19/2021 3:29:19 PM

USRINSAPP (8/12) 1 of 5 Dallas 800‐232‐5830 Scottsdale 800‐949‐5245 Santa Ana 800‐856‐7035 INSURANCE PROFESSIONALS ERRORS & OMISSIONS AND RELATED PROFESSIONAL LIABILITY INSURANCE

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IGP Specialty Dental Professional Plus Overview.pdf

IGP Specialty Agency Agreement_08 (1).pdf

ACORD 130.pdf

ACORD 131.pdf

Artisan Contractors Supplemental Application.doc

Habitational Liability Application.doc

Welding General Liability Supplemental Application.doc

U.S. Risk Call Center-Answering Service E&O Application.pdf

U.S. Risk Cyber Security and Privacy Questionnaire.pdf

U.S. Risk Insurance Agents Application Including Group Benefit Supplement.pdf

IGP Specialty Individual Practitioners Application.pdf

IGP Specialty Medical Directors PL Application.pdf

IGP Specialty Pharmacy PL-GL Application.pdf

IGP Specialty Social Services Agencies Application.pdf

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