PI-ACT-1953-2(05/10) Page 1 of 3
__________________________________________________________________________
Name of Insurance Company to which Application is made (herein called the “Insurer”)
ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION
AUDIT ENGAGEMENTS SUPPLEMENT
Supplement No. 2
1. Full name of the Applicant Firm:________________________________________________________________
2. Provide the number of Audit Engagements conducted within the last fiscal year in each of the following
categories:
TYPE OF AUDIT NO. OF AUDITS % OF GROSS BILLINGS
a. Agricultural Procedures & Cooperatives
b. Airlines
c. Financial Institutions (Please complete Supplement #4)
d. Brokers and Dealers in Securities
e. Casinos
f. Colleges and Universities
g. Common Interest Realty Associations
h. Construction
i. Benefit Plan
j. Federal Government Contractors
k. Providers of Health Care Services
l. Investment Companies
m. Non-Profit Organizations
n. Oil and Gas Producers
o. Property and Liability Insurance Co.
p. State and Local Government Units
q. Life Insurance Companies
r. Voluntary Health and Welfare Organizations
s. Factoring Companies
t. Real Estate
u. Real Estate Investment Trust
v. Manufacturing
w. Retailing
x. Entertainment/Sports
y. Other (Please specify)
TOTAL = audit percent indicated on the Application:
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PI-ACT-1953-2(05/10) Page 2 of 3
3. Has your firm provided audit services for factoring companies in the past five years?
Yes No
If yes, please provide details below:
FACTORING COMPANIES CLIENT BASE
SERVICES RENDERED
NO. OF YEARS
AUDITING CLIENT
4. Has your Firm performed audits of publicly held companies in the last three (3) years?
Yes No
If yes, also complete the SEC Supplement No. 3
If yes, list the number of audits performed: ________________ Industry type: ______________________________
4a. Were any of the aforementione
d audits subsequently used in an Initial Public Offering?
Yes No
If yes, please provide an explanation:____________________________________________________________
___________________________________________________________________________________________
5. During the last three (3) years, did any of your government entity clients invest in derivative securities?
Yes No If yes, please provide an explanation: _____________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
6. Does your firm apply generally accepted auditing standards to all audit engagements?
Yes No
7. Does your firm have and use the applicable AICPA industry audit guides?
Yes No
8. Please describe your Firm’s continuing education requirements for your CPA’s who undertake audit
engagements:________________________________________________________________________________
___________________________________________________________________________________________
9. What is the source of your audit programs? (PPC, AICPA)___________________________________________
10. Does your firm use the AICPA Audit Risk Alerts?
Yes No If no, please explain how you keep current
on the changing standard of care for you audit clients: ____________________________________________
___________________________________________________________________________________________
I understand information submitted herein becomes a part of my Philadelphia Insurance Companies
Accountants’ Professional Liability Application and is subject to the same conditions as stated on the
application.
__________________________________________ _____________________________________________
Name (Please Print) Title (Must be Partner or Officer)
__________________________________________ _____________________________________________
Signature Date
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PI-ACT-1953-2(05/10) Page 3 of 3
ADDITIONAL INFORMATION
This page may be used to provide additional information to any question on this
application. Please identify the question number to which you are referring.
__________________________________________ _____________________________________________
Signature Date
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