Fillable ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION VALUATION AREA OF (Philadelphia Insurance Companies)

Fill Online, Printable, Fillable, Blank ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION VALUATION AREA OF (Philadelphia Insurance Companies) Form

Use Fill to complete blank online PHILADELPHIA INSURANCE COMPANIES pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION VALUATION AREA OF (Philadelphia Insurance Companies)

On average this form takes 16 minutes to complete

The ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION VALUATION AREA OF (Philadelphia Insurance Companies) form is 3 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 65 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your Philadelphia Insurance Companies forms online.

BROWSE PHILADELPHIA INSURANCE COMPANIES FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Valuation Area of Practice Supplement Page 1 of 3 Ed.10/2010
ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION
VALUATION AREA OF PRACTICE SUPPLEMENT
Name of Insurance Company to which Application is made (herein called the “Insurer”)
1. Full name of the Applicant Firm:
2. Provide the following data regarding the number of valuations performed within your last fiscal year in each of
the following categories:
TYPE OF VALUATIONS PERFORMED NO. OF VALUATIONS % OF VALUATION BILLINGS
a. Publicly Traded Companies
b. Marital Assets
c. Software Companies
d. Intellectual Property Valuation
e. Privately Held Companies (not otherwise listed)
f. Financial Institutions
g. Trust / Estate Assets
h. Donated Property / IRS Valuation
i. Conservation Easements
j. Real estate or Real Estate Investment Trusts
k. Litigation Support (not otherwise listed)
l. Investment Companies
m. Natural Resources
n. Manufacturing
o. M&A Valuations Consulting
p. Fraud Deterrence
q. Forensic Accounting
r. Personal Property Appraisals
TOTAL = Valuation percent indicated on this supplement:
3. Has the Applicant Firm provided a valuation used in any public securities offering within the
past five (5) years?
Yes No
If yes, please provide details below, including size of offering and portion (% or $) of
the offering represented by the applicant’s work product:
4. How many of the Applicant Firm’s members maintain a membership in the National
Association of Certified Valuation Analysts:
Clear Application
Print Application
Valuation Area of Practice Supplement Page 2 of 3 Ed.10/2010
5. How many of the Applicant Firm’s members hold each of the following designations?
Certified Valuation Analyst:
Accredited Valuation Analyst:
Certified Forensic Financial Analyst and/or Certified Fraud Deterrence Analyst:
6. Please describe the continuing education requirements for the Applicant Firm’s CPAs who
undertake valuation engagements:
Are all members in compliance with these requirements? Yes No
If no, please explain:
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/Type) Title (MUST BE SIGNED A PARTNER OR OFFICER)
_______________________________________
Signature Date
The above signed warrants that he/she is authorized and has the power to complete and execute this Application,
including the Warranty Statement on behalf of the Applicant and their respective Directors, Officers or other
insured persons.
Produced By: (Section to be completed by Producer/Broker)
Producer Agency
Producer License Number Agency Taxpayer ID or SS Number
Address (Street, City, State, Zip)
Clear Application
Print Application
Valuation Area of Practice Supplement Page 3 of 3 Ed.10/2010
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
Clear Application
Print Application
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

ACCOUNTANTS PROFESSIONAL LIABILITY INSURANCE APPLICATION VALUATION AREA OF (Philadelphia Insurance Companies)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 7 November 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document