COVER-PRO
SM
APPLICATION
PROJECT MANAGER (NON CONSTRUCTION) SUPPLEMENT
1. Full name of the Applicant Firm:
2. Do any key professionals of the Applicant have the
following
cert
ification
s
?
Project Management Professional (PMP)
Certified Associate in Project Management (CAPM)
OPM3 Certification (Organization Project Management Maturity Model)
Program Management Professional (PgMP)
3. Does the Applicant employ; whether on a permanent, temporary or independent contractor basis;
architects, engineers, medical doctors, or construction contractors?
Yes No If yes, pro
vide details.
ADDITION
AL INFORMATION
This section may be used to provide additional information to
any question on this application. Please
identify the question number to which you are referring.
I understand that the information submitted herein becomes a part of my Philadelphia Insurance
Companie
s Cover-Pro
sm
and is subject to the same conditions as stated on the application.
Name (Please Print) Title (Mus
t be Principal, Partner or Officer
)
__________________________________________
Signature Date
PI-PLSP-PJSUPP 08/
10 Page 1 of 1
