Common 
Applications

Contact us for supplemental applications not shown here

  1. ACORD™ APPLICATIONS ACCEPTED  - fully completed applications are essential to clear submissions for underwriter assignment. Contact us for assistance. 
  2. EASY AND SIMPLE - cut down turnaround time by providing prior, current carrier information, loss experience and target pricing. At a minimum, a complete description of all risk operations and exposures is required. 
  3. SUPPLEMENTAL APPLICATIONS - supplemental applications are considered from any carrier. Dozens of risk specific supplementals are available.

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46%

Optional Coverage

62%

Expiration Date

61%

Target Pricing

41%

Current Carrier

74%

Underwriting Details

Common
Applications

Contact us for additional applications not shown here. Fully competed applications are essential to achieve the best terms from us. 

Surplus Lines Disclosure and Acknowledgement
Statement of Diligent Effort 
FSLSO Matrix
Pre-Existing Damage Statement
Commercial Policy Change Request
Statement of No Loss
UM Selection/Rejection
Property Coverage Specifications Supplemental
Hired and Non-Owned Liability
Agent Broker of Record Change
Policy Change Request
Underinsurance Notice
Arson Control
Business Income Worksheet
Building Safety Report
Loss Notice - General Liability
Loss Notice - Property
Loss Notice - Automobile 

Contact us for supplemental applications not shown here. Dozens of supplemental applications available, more coming soon.

Commercial General Liability
Commercial Property Application
Miscellaneous Scheduled Property
Miscellaneous Professional Liability
Commercial Auto Physical Damage
Special Event Liability
Owners & Contractors Protective (OCP)
Farm and Ranch
Builders Risk
Open Cargo 
Contractors Pollution  
Restoration and Mold Contractors
Artisan Contractors
Machinery or Equipment Repair
Mobile Home Park
Habitational 
Apartments Mixed Use
Dwelling Supplement
Convenience Grocery Store
Service Station Supplement
Hospitality
Restaurant Bar Tavern
Teen Nightclub
Mobile Concessions
Pedicab Companies
Health, Spa and Exercise
Church
Clubs
Manufacturing
Distributors and Wholesalers
Child Care Day Services
Children’s Indoor Playcenter
Amusement Centers
Petting Zoo
Miniature Train Supplemental
Equipment and Party Rental
Inflatable Moonwalk, Bounce House
Horse Drawn Vehicle Rides
Go-Kart Tracks
Vocational Schools
Employee Leasing
Event Party Wedding Planners
Event Promoters
Roofing
General Contractors
Remodeling Supplemental
Crane Rental
Pressure Cleaning
Welding
Janitorial Services
Landscape, Tree and Lawn Contractors
Animal Removal Services
Alarm and Monitoring
Beauty, Barber, Day Spa
Pawn Shops 
Tattoo Parlors
Pest Control
Security Guard and Patrol
Solar or Wind Energy
Landowner’s Supplemental
Vacant Property
Vacant Land
Property Manager
Home Inspectors
Rural Water Company
Residential Condominium Unit-Owner 
Products Completed Operations 
Hired Non-Owned Auto
Additional Insured Application
Bailees Customers Goods
Discontinued Products
Umbrella Excess
EZ Contractors
Exhibition Floater
Cooking Supplement
Stop Gap – Employers’ Liability
Pesticide Herbicide Questionnaire
Cosmetic Manufacturing
Fertilizer Manufacturing
Trailer Manufacturing
Metal Fabrication

Our professional liability programs focus on asset managers, insurance agents and brokers, insurance companies, lawyers, media and film companies, tech companies and other miscellaneous professionals. Together, with our limited group of partners, we work to fully understand specific needs in order to provide comprehensive coverage.

Insurance Agents and Brokers E&O Application
Asset Managers Professional & Management Liability Application 
Architects and Engineers Professional Liability Application
Personal Lines Insurance Agents and Brokers E&O Application
Technology / Media / Cyber Application
Insurance Company Management and Professional Liability Application 
Media and Entertainment Application 
Lawyers Professional Liability Application
Miscellaneous E&O Application Quick Quote

Best-in-class environmental products for a broad scope of insureds which, through their work or operations, have an exposure to pollution-related losses. Our suite of products is offered on a surplus lines basis.

Environmental Contractors and Consultants Application
Environmental Impairment Liability (EIL) Application 
Transportation Pollution Liability 
Restoration Contractors Liability 

Contact us for supplemental applications not shown here. Dozens of supplemental applications available, more coming soon.

Commercial General Liability
Commercial Property Application
Miscellaneous Scheduled Property
Miscellaneous Professional Liability
Commercial Auto Physical Damage
Special Event Liability
Bailees Customers Goods
Motor Truck Cargo
Contractors Equipment
Warehousemens Legal Liability
Warehouse CGL Application
Installation Coverage
Owners & Contractors Protective (OCP)
Comprehensive Personal Liability (CPL)
Lawyers Professional Liability Application
Farm and Ranch
Personal Umbrella
Builders Risk
Open Cargo 
Contractors Pollution  
Restoration and Mold Contractors
Artisan Contractors
Machinery or Equipment Repair
Mobile Home Park
Habitational 
Apartments Mixed Use
Dwelling Supplement
Convenience Grocery Store
Service Station Supplement
Arson Control
Hospitality
Restaurant Bar Tavern
Teen Nightclub
Mobile Concessions
Pedicab Companies
Health, Spa and Exercise
Church
Garage Coverage - Garage Application
Insurance Agents and Brokers E&O
Clubs
Manufacturing
Distributors and Wholesalers
Motor Truck Cargo
Contractors Equipment
Warehousemens Legal Liability
Child Care Day Services
Children’s Indoor Playcenter
Amusement Centers
Petting Zoo
Miniature Train Supplemental
Equipment and Party Rental
Inflatable Moonwalk, Bounce House
Property Coverage Specifications Supplemental
Horse Drawn Vehicle Rides
Go-Kart Tracks
Vocational Schools
Employee Leasing
Event Party Wedding Planners
Event Promoters
Roofing
General Contractors
Remodeling Supplemental
Crane Rental
Pressure Cleaning
Welding
Janitorial Services
Landscape, Tree and Lawn Contractors
Animal Removal Services
Alarm and Monitoring
Beauty, Barber, Day Spa
Pawn Shops 
Tattoo Parlors
Pest Control
Security Guard and Patrol
Solar or Wind Energy
Landowner’s Supplemental
Vacant Property
Vacant Land
Property Manager
Home Inspectors
Rural Water Company
Residential Condominium Unit-Owner 
Products Completed Operations 
Hired Non-Owned Auto
Additional Insured Application
Discontinued Products
Umbrella Excess
EZ Contractors
Exhibition Floater
Cooking Supplement
Stop Gap – Employers’ Liability
Pesticide Herbicide Questionnaire
Cosmetic Manufacturing
Fertilizer Manufacturing
Trailer Manufacturing
Metal Fabrication
Liquor Liability
Liquor Liability/CGL
Liquor Liability Special Event
Marine Contractors Legal Liability 

E&O Prevention
PRIOR TO BINDING

In our experience working with insurance organizations, E&O prevention should begin prior to binding coverage. Below are some recommended best practices.

Review and compare. Carefully review all applications and updates at renewal and compare them to quotes before binding. Ensure any changes in forms do not leave gaps based on the insured’s current operations.

Include confirmations. In your bind orders, include confirmations with respect to what additional insured endorsements are acceptable, when they can be attached to certificates, and what other forms can be attached. In addition, address your authority to issue certificates for policies placed through wholesale brokers or other non-direct relationships. Also, include who is responsible for notifying holders with 30-day cancellation notices.

Have a discussion. Communicate with your insured about the types of coverage they have available and the terms and conditions under which additional insured, waiver of subrogation, notice of cancellation, and other extensions are available. Encourage them to review contractual requirements with you before the contract is signed.

Set expectations. Your insured must understand the limits of your responsibility for reviewing their contracts and agreements. Make it clear that you will only be looking at the insurance requirements and that any other provision should be reviewed by an attorney. Also, set expectations around how you will handle certificate requests that are not in compliance with their insurance program.

Source: Avoiding Certificate of Insurance E&O: Part 1 by Brenda Grow | January 12, 2022

CONTACT US 


Firestone Agency of Florida, Inc.
Wholesale Insurance Brokers | MGA

Boca Raton, Florida
International Plaza
7280 West Palmetto Park Road
Suite 106-N
Boca Raton, FL 33433
Call Us (954) 341-8331

Ponte Vedra, Florida 
Valley Ridge Professional Park
4210 Valley Ridge Blvd
Suite 127-128
Ponte Vedra, FL 32081
Call Us (800) 683-1150

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