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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: ______________

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

Cyber Insurance Short Application (Optional) Applicant's DBA Applicant's address (Optional) PO Box, Suite, Floor, Unit, etc. Applicant’s previous fiscal year-end revenue and current year-end

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

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Managed by: Scott Carroll, Director of Take1 1551 N. Tustin Ave., Suite 430 Santa Ana, CA 92705 Phone: (800)856-7035 scott@take1insurance.com Application D.I.C.E. Supplemental (Documentary

MULTI-FACTOR AUTHENTICATION (MFA) GUARDING AGAINST ATTACKS MFA helps protect against unauthorized access, data breaches and password-based cyber attacks. It serves as a second barrier by verifying

STATE OF THE PUBLIC D&O MARKET KEY INFLUENCERS OF CURRENT D&O MARKET TRENDS With rates up for virtually every D&O risk, securities class actions and litigation following high-profile events lead

CYBERSECURITY: SEC DISCLOSURE GUIDANCE The Securities and Exchange Commission has adopted rules surrounding disclosures of material cybersecurity incidents. In addition, requirements for annual