Fillable Private Investigators Application 1. Name (Complete name as (All Risks, Ltd)

Fill Online, Printable, Fillable, Blank Private Investigators Application 1. Name (Complete name as (All Risks, Ltd) Form

Use Fill to complete blank online ALL RISKS, LTD pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Private Investigators Application 1. Name (Complete name as (All Risks, Ltd)

On average this form takes 24 minutes to complete

The Private Investigators Application 1. Name (Complete name as (All Risks, Ltd) form is 2 pages long and contains:

  • 2 signatures
  • 44 check-boxes
  • 66 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your All Risks, Ltd forms online.

BROWSE ALL RISKS, LTD 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
 
National Specialty Programs
Toll Free: 800-366-5810 • Fax: 410-828-8179
Contact us: programs@ryansg.com
Private Investigators Application
1. Name
____________________________________________________________________________________________________________
(Complete name as it should appear on the policy including Corp., Ltd., Etc.)
2. Address ___________________________________________________________________________________________________________
No. Street City County State Zip Code
€ Corporation € Other
Current Policy Year (next 12 months)
Annual Revenue (sales) $
Annual Payroll* $
Amount Paid to Subs $
*Employees/owners who perform private investigation services. Do not include clerical or sales payroll.
Narcotics Surveillance Online Searches Undercover Operatives
Auto Repossession Accident Reconstruction Guard Service/Property Protection
Bodyguard/Exec. Protection Arson Investigations (C&O) Process Service
Store Detective (Arrests) Attorney/Legal Investigations Subpoena Service
Polygraph/PSE Exams Insurance Fraud Investigations Pre-employment Backgrounds
Foreclosure Sales Locate People/Witnesses Electronic Countermeasures
Bank Account Searches Domestic Surveillance Other (Describe)
Asset Searches
Yes Yes No
Additional Coverages – Check all that apply
Additional Insureds Stop Gap
Waiver of Subrogation
Primary Wording
Individual Blanket
Individual Blanket
Individual Blanket
No If yes, are they licensed?
Per Project Aggregate
Employee Benefits Liability
Hired/Non-owned Auto
INFORMATION PROVIDED, ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR
OTHER PERSON, FILES AN APPLICATION FOR INSURANCE CONTAINING FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE
OF MISLEADING INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT,
WHICH IS A CRIME BY SIGNING THIS APPLICATION, THE SIGNOR WARRANTS THAT TO THEIR BEST KNOWLEDGE ALL
INFORMATION GIVEN IS TRUE AND ACCURATE
________________________________________ ______________________________________ ____________________
Name (type or print) Signature Date
NOTICE TO PRODUCERS
: THE PRODUCER HEREBY WARRANTS THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE
AND CORR
ECT TO THE BEST OF THEIR KNOWLEDGE.
______________________________ _________________________________ _______________ __________________________
Name (type or print) Signature Date License #
3. Cont
act ____________________________ Telephone ( ) _______________________ Fax ( ) ________________________
4. Insureds' Email Address
5. Total number of employees: ________ Full Time ________ Part Time
6. Date established __________________ License No. ______________________ € Sole Proprietor € Partnership
7. Policy proposed effective date ____________________ to ____________________
8. Please fill out the table below for the current and previous policy year:
vided: Please check services that you now provide or would provide
if requested.
9. Services pro
y of your employees carry a firearm?10. Do you or an
NOTICE TO APPLICANTS: THIS APPLICATION MUST BE COMPLETED IN FULL AS THE QUOTE WILL BE BASED SOLELY ON THE
ARF 2858 (PI) 010721 Page 1 of 2
RSGprograms.com
click to sign
signature
click to edit
click to sign
signature
click to edit
Optional Coverages
(please attach an ACORD application)
Property
Business Auto
EDP
Umbrella/Excess
C
r
i
m
e
/
E
m
p
l
o
y
e
e Dishonesty
Contractors Equipment
Workers Compensation
Employment Related Practices
U
mbrella/Excess Questionnaire
(
P
l
e
a
s
e
c
o
m
p
l
ete only if desired.)
1. With the exception of leinholders, are any vehicles not solely owned by and registered
to the applicant?
€ Yes
€ No
2. Do over 50% of the employees use their autos in the business?
€ Yes
€ No
3. Is there a vehicle maintenance program in operation?
€ Yes
€ No
4. Are any vehicles leased to others?
€ Yes
€ No
5. Are any vehicles customized, altered or have special equipment?
€ Yes
€ No
6. Do operations involve transporting hazardous material?
€ Yes
€ No
7. Any vehicles used by family members or non employees?
€ Yes
€ No
If so, please identify in remarks.
Remarks:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
10. Does insured have a written personal use policy including: who may and may not drive
are viol
ated?
Yes No
8. Does insured review MVRs at time of hire and annually for all driving employees?
Yes
No
9. Does insured have MVR standards in place, and an action plan if those standards
11. Does insured have a Fleet Safety program in place? Yes No
Yes No
12. Does the applicant have a specific driver recruiting method? € Yes € No
13. Are any drivers not covered by Workers Compensation? € Yes € No
14. Any vehicles owned but not scheduled on this application? € Yes € No
a company owned vehicle, that the company vehicle
(s) may or may not be used for outside
business, and consequences for violation of the policy?
ARF 2858 (PI) 010721
Page 2 of 2
RSGprograms.com
RSG National Specialty Programs is a unit of the RSG Underwriting Managers division of RSG Specialty, LLC, a Delaware limited liability company based in Illinois. RSG Specialty, LLC, is a
subsidiary of Ryan Specialty Group, LLC (RSG). RSG National Specialty Programs works directly with brokers, agents and insurance carriers, and as such does not solicit insurance from the
public. Some products may only be available in certain states, and some products may only be available from surplus lines insurers. In California: RSG Specialty Insurance Services, LLC
(License # 0G97516). ©2021 Ryan Specialty Group, LLC
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

Private Investigators Application 1. Name (Complete name as (All Risks, Ltd)

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 20 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document