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Specialty Underwriting | SWD Program REV 12.02.2020 Building solid, professional relationships is the foundation of success. U.S. Risk is committed to this concept and considers it one of the

Specialty Underwriting | Oil & Gas Program Building solid, professional relationships is the foundation of success. U.S. Risk is committed to this concept and considers it one of the most

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

Take1 is a division of U.S. Risk, LLC and its affiliate companies. U.S. Risk, Take1, and the Take1 logo are registered trademarks of U.S. Risk Insurance Group, Inc. Copyright ©2022 U.S. Risk

Take1 is a division of U.S. Risk, LLC and its affiliate companies. U.S. Risk, Take1, and the Take1 logo are registered trademarks of U.S. Risk Insurance Group, Inc. Copyright ©2022 U.S. Risk

Specialty Underwriting | Wind Deductible Buyback Program Building solid, professional relationships is the foundation of success. U.S. Risk is committed to this concept and considers it one of the

PAGE 1 OF 3 Claims History Supplemental Information Form U.S. Risk, LLC | 14241 Dallas Parkway, Suite 850, Dallas, Texas 75254 U.S. Risk HealthcarePros U.S. Risk HealthcarePros is a Specialty

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

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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 

Long Term Care Professional and General Liability Application COVID-19/Communicable Disease Supplement Copyright ©2020 03/2020 Instructions: The requested information is necessary before a