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MOTORCYCLE SCHOOL SUPPLEMENTAL APPLICATION PRG 142062 (12-22) ©All rights reserved. Page 1 of 2 Applicant Name: _________________________________________________________________________________

PRG 142063 (12-22) ©All rights reserved. Page 1 of 2 MUD BOG / SAND DRAG SUPPLEMENTAL APPLICATION EVENTS SCHEDULED: □ Mud Bog □ Sand Drag COMPETITION AREA: Indoor or Outdoor event?

PRG 142068 (12-22) ©All rights reserved. Page 1 of 1 SUPPLEMENTAL APPLICATION ROADCOURSE NAME OF TRACK: Year Track Built: Age of Track Surface: Length of Track: Track Surface Material (

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

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

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:

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

COMPLETE ALL SECTIONS PROMOTER TRACK SANCTIONING BODY / PROMOTER NHRA  TRACK PROMOTED  WDRA  IMCA  IHRA  OTHER  _____________________ EVENT TYPE DRAG  OVAL  ROAD

Release and "Waiver of Liability Assumption of Risk and Indemnity Agreement Name of Track and/or Event: _______________________ Event Date(s) : __________ _ IN CONSIDERATION of being permitted to

Specialty Underwriting Entertainment Underwriting Program Loan-Out Corporations Features • Take1 is one of the largest General Agent with stated carrier Underwriting Authority focused on

SUBMISSION REQUIREMENTS • Acord Forms for all lines required: • General Info (125) • General Liability (126) • Property (140) • Floater (146) • Auto (127) • EDP (148) • Excess or Umbrella (

Community Association Insurance Program OUR WIA PROPERTY PROGRAM ■ Territory: Connecticut, Delaware, Maine, Maryland, New Hampshire, New Jersey, Vermont and Virginia ■ We provide primarily

Animal Welfare Non-Profits Program Fact Sheet

Veterinary Professional Plus Fact Sheet

Agency Resources is a Division of Innovation Growth Partners Specialty, LLC | igpspecialty.com REV 01.20.26 CONTACT US Traci Huskey (941) 444-1659 | traci.huskey@igpspecialty.com Brian Rudolph (

Supporting brokers with workers’ compensation solutions Workplace injuries can have a debilitating effect on employees and business operations. Establishing a workers’ compensation program that

A G F H D E B C I TheD&ODictionary A G F H D E B C I In the rapidly evolving environment of executive risk, keeping up with the latest terms and technical components of a Directors’