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U.S. Risk, LLC is now sending payments via EFT/ACH. Please fill out the form below and return it via email to: accountingmail@usrisk.com AUTHORIZATION AGREEMENT Producer Name: ______________

Claim-Reporting-Procedures-3-2014-Western-Litigation.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/~misc/claim-reporting-procedures-3-2014-western-litigation.pdf?v=5c9fb264

4/19/2021 3:18:22 PM

CRPWLI(3/14) Professional Liability Programs Division U.S. Risk Underwriters CLAIM REPORTING PROCEDURES All claims or incidents which might reasonably be expected to give rise to a

Condos-HOAs General Liability Application.doc

https://www.usrisk.com/siteassets/documents/forms-and-applications/apps-page-only/commercial/condos-hoas-general-liability-application.doc?v=619c6fef

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

Special Events General Liability Application.doc

https://www.usrisk.com/siteassets/documents/forms-and-applications/apps-page-only/commercial/special-events-general-liability-application.doc?v=66fb6372

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 Energy and Environmental SPL Program Application.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/ee/us-risk-energy-and-environmental-spl-program-application.pdf?v=6de32ed1

4/19/2021 3:31:41 PM

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U.S. Risk Oilfield Consultant Questionnaire.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/ee/us-risk-oilfield-consultant-questionnaire.pdf?v=6f09d0b7

4/19/2021 3:31:41 PM

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U.S. Risk Oilfield Pumper Gauger Questionnaire.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/ee/us-risk-oilfield-pumper-gauger-questionnaire.pdf?v=6f6c06ae

4/19/2021 3:31:41 PM

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U.S. Risk Financial_Property Loss Form.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/financial/us-risk-financial_property-loss-form.pdf?v=71b94a78

4/19/2021 5:37:12 PM

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Healthcare Pros Ambulance Services Application.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/health/main/healthcare-pros-ambulance-services-application.pdf?v=74068e42

4/19/2021 3:33:20 PM

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Healthcare Pros Durable Medical Equipment Application.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/health/main/healthcare-pros-durable-medical-equipment-application.pdf?v=752d3028

4/19/2021 3:33:20 PM

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Healthcare Pros Misc Healthcare Application.pdf

https://www.usrisk.com/siteassets/documents/forms-and-applications/health/main/healthcare-pros-misc-healthcare-application.pdf?v=783edfe0

4/19/2021 3:32:26 PM

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