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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

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

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

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

Dental Indication Form

PAGE 1 OF 6©2025 Innovation Growth Partners Specialty, LLC. All rights reserved. | igpspecialty.com | Rev. 03.01.25 Miscellaneous Healthcare PL/GL Application IGP Specialty | 14241 Dallas

©2025 Innovation Growth Partners Specialty, LLC. All rights reserved. | igpspecialty.com Rev. 03.01.25 Resident Profile Application IGP Specialty | 14241 Dallas Parkway, Suite 850 | Dallas,

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Third-Party Administrators PL Application IGP Specialty | 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254 PAGE 1 OF 6©2025 Innovation Growth Partners Specialty, LLC. All rights reserved.

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Builders' Risk Renovations Supplemental Application Remodel / Renovation / Rehabilitation *** THIS SUPPLEMENTAL APPLICATION MUST BE ATTACHED TO THE ACORD GENERAL APPLICANT INFORMATION

Builders' Risk Prior Start Supplemental Application DATE: TO: COMPANY: ------------------ PHONE: FAX: TO BE COMPLETED ONLY IF THE JOB HAS STARTED Re: Name: Quote#: Please answer the

Please complete for each location which provides wine storage. NAMED INSURED Name: __________________________________________ Location Address: __________________________________________

100 Glen Eagles Court Carrollton GA 30117 800.842.8917 www.safehold.com www.safehold.com Solar Panel Questionnaire If the insured wishes for coverage to apply to the solar panels and the

PAGE 1 OF 2 Abuse and Molestation Supplemental Application 14241 Dallas Parkway, Suite 850 | Dallas, Texas 75254 StaffPak is a division of Innovation Growth Partners Specialty, LLC | Rev.

Application D.I.C.E. Supplemental (Documentary Industrial Commercial Educational) Managed by: Scott Carroll, Director of Take1 1551 N. Tustin Ave., Suite 430 Santa Ana, CA 92705 Phone: (800)856

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