The Insurance Marketplace ® Questionnaire

2017 EDITION, DECEMBER 2016

Name of Company, Underwriting Group, Risk Retention Group, Specialty Broker, or Program Administrator (as you wish your listing to appear)
Company:
Address:
City: State/Province: Zip: Country:
Telephone: Toll Free: Fax:
Email:
URL:
This is your questionnaire for coverage listings in the 2017 National Market Directory.
As you complete your questionnaire, please check the appropriate column - Program Administrator/Underwriting Manager or Other Market Sources - for each coverage that you want to appear under. We will make the distinction when we list you.
Except for ADVERTISERS, whose LISTINGS ARE FREE, there is a charge based on the number of categories. Please consult the fee schedule at the end of questionaire.
If you choose to advertise, even regionally, you are eligible to appear with your coverages in the National Market Directory, even though you might not otherwise qualify for such listings. For details, please call our advertising department at 1-800-428-4384 or 317-582-1600, FAX 317-816-1000 or e-mail Eric Hall at ehall@roughnotes.com or Dick Schoeninger at dick@roughnotes.com

Listing Criteria and Marketing Information

The criteria for listing an insurer, managing underwriter, managing general agent or excess and surplus lines broker in the 2017 edition of The Insurance Marketplace® are:

Insurors - licensed in one or more states with net premiums (2015) of $2 million (U.S.) or more.

Managing Underwriters - represent one or more companies for specific classes or for all property and casualty classes and operate in all states in which the company operates.

Managing General Agents - represent companies and operate in one of The Insurance Marketplace® geographical territories.

Excess and Surplus Lines Brokers - have binding contracts with Lloyd's or domestic and alien non-admitted insurers.

1. Indicate the category which best describes your organization:
     
       
     
2. Please answer the following questions related to marketing:
  A. List any additional nonstandard or unusual forms of insurance (not listed in the questionnaire) which your organization writes:
 
  B. List all states in which your organization is operating through agents on an admitted basis:
 
  C. List all states in which you are operating on a non-admitted basis:
 
  D. Countries:
 
3. If you are an Insurance Company, how are your special facilities marketed:
       
         
4. If you operate as a Program Administrator, Risk Retention Group, Managing Underwriter, MGA or E&S Broker, are your facilities available to:

On the following pages, please check each type of insurance your company writes and whether you offer the coverage as a program administrator/ underwriting manager, or as another market source. Before returning this questionnaire please answer the marketing questions on page one. We also request that a company or individual in charge of the Excess and Surplus or Specialty Lines Department sign the questionnaire . Return to : The Insurance Marketplace, c/o The Rough Notes Company, Carolyn Pringle, Project Coordinator, P.O. Box 1990, Carmel, Indiana 46032-4990. Fax: 317-816-1000.

Please check only one, Program Administrator or Other Market Sources.
For Office Use: Written by Written by
COVERAGES Prg. Adm.
/Undwrtg. Mgr 		  Other Mkt. Sources COVERAGES Prg. Adm.
/Undwrtg. Mgr 		  Other Mkt. Sources
Abortion Clinics Professional Liability 1 Abstracters Professional Liability 2
Accountants Professional Liability 3 Accreditation Programs Errors and Omissions 4
Actuaries Professional 5 Acupuncture Specialists Liability 6
Adjusters Errors and Omissions 7 Adoption Agencies Errors and Omissions 602
Adult Book Stores 570 Adult Entertainment Film Production 768
Advertising Agency Liability 8 Agent Market Intelligence Resources 787
Air Cargo Insurance 10 Aircraft Hull and Liability 11
Aircraft Products Liability 12 Aircraft Spare Parts 13
Airport Owners/Operators Liability 14 Airport Property And Aviation–Related Risks 665
Alcohol and Drug Rehabilitation Centers Liability 15 All–Terrain Vehicles 16
Alternative Energy Plants 17 Amateur Athletic Programs (Colleges and Clubs) 18
Ambulance Service Malpractice 19 Ambulatory Surgery Centers 686
American Expatriates 73 Amusement Devices – Coin Operated 20
Amusement Parks and Fairgrounds 21 Amusement Rides 22
Anesthetists Professional Liability 23 Animal Rescue Organizations 790
Animal Shelter 811 Anhydrous Ammonia Dealers Liability 24
Animal Farms (Exotic) 25 Animal Mortality 26
Animal Rides 28 Answering Services Errors and Omissions 29
Antique Aircraft Insurance 30 Antique and Classic Automobile Insurance 31
Antique and Classic Boats 32 Apartment Complexes 622
Appraisers Errors and Omissions 33 Aquaculture Operations 34
Arborists 804 Archery Clubs 35
Architects and Engineers Professional 36 Armored Car Services 37
Art Collections 687 Art Galleries 688
Asbestos Abatement Consultants Professional Liability 40 Asbestos Abatement Contractors 41
Asbestos and Lead Paint Abatement Bonds 42 Assisted Living Facilities 650
Associations Professional Liability 43 Association–Sponsored Mass Marketing Programs 44
Athletic Event Cancellation Insurance 689 Auction Houses 45
Auctioneers Errors and Omissions 46 Auto Dismantlers/Auto Recyclers 655
Auto Salvage Yards 690 Auto Service Centers 679
Automatic Car Wash Services 47 Automobile and Snowmobile Racing Liability (Spectator) 48
Automobile and Truck Rental – Daily 49 Automobile Dealers 50
Automobile Excess Liability 51 Automobile Insurance Plans Excess Liability 52
Automobile Insurance Plans Physical Damage 53 Automobile Leasing Contingent Liability 54
Automobile Leasing Contingent Physical Damage 55 Automobile Nonstandard Liability 56
Automobile Nonstandard Physical Damage 57 Automobile Physical Damage (Kits/Replicas/Custom Cars) 58
Automobile Repossessors Liability 59 Automobiles – Sport and High Performance Cars 60
Bailees Customers Insurance 61 Background Check Services 808
Bankers Blanket Bond – High Limits 62 Barber Shop Liability 63
Bars 64 Battered Persons Facilities 65
Beauty Shop Liability 66 Bed and Breakfast Inns 67
Bicycle Dealers 691 Bicycle Manufacturers 692
Billiard Parlors 572 Bingo Halls 573
Biotechnology Liability 693 Birds (Exotic) 69
Birth Centers Liability 70 Blood Banks Professional Liability 71
Bloodstock Insurance 72 Boat Dealers 694
Boat Manufacturers 695 Boat Rental 812
Boatyards or Boat Repair and Servicing Operations 696 Bobtail or Deadheading Liability (Truckers) 75
Body Piercing Liability 76 Boiler and Machinery Coverage aka Equipment Breakdown Coverage 697
Bowling Centers 77 Bridge, Tunnel, and Elevated Highway Construction 698
Broadcast Stations 603 Brownfields Development Sites 604
Buffer Layer Liability 214 Builders Risk 79
Builders Risk – including Design Error 80 Building Equipment Erection and Installation 699
Bumbershoot Liability 81 Bungee Jumping Events 82
Burglar, Fire Alarm and Safety Equipment Company Liability 83 Bus Conversions 100
Buses 84 Business Legal Expense Insurance 85
Business Travel Accident 86 Cable TV Liability 700
Campers and Camper Vans 87 Campground Owners Liability 88
Canoe Trips/River Rafting 89 Capacity or Excess Property Insurance 90
Caribbean Property 568 Carnivals and Circuses 92
Carpentry Work Contractors 701 Casino/Gaming Risks 93
Catered Affair Cancellation Insurance 94 Caterers Errors and Omissions 95
Celebrity or SpokeSperson Death, Disability or Disgrace 103 Cemetery Professional Liability 96
Charter Boats 97 Charter Buses 98
Check Cashing Services 101 Chemical Manufacturers 102
Chemical Distributors 799 Chiropractors Professional Liability 104
Christmas Tree Lots 105 Churches 106
Clergy Professional Liability 108 Clinical Laboratory Malpractice 109
Coal Mining Operations 110 Coal Trucks Physical Damage 111
Coastal Properties 702 Coatings and Adhesives Manufacturers 605
Coin and Stamp Dealers Insurance 112 Coin–Operated Dry Cleaners and Laundries 113
Coinsurance Deficiency Coverage 114 Collateral Protection Insurance 115
Collectibles 232 Collection Agents Errors and Omissions 116
Commercial Autos–Miscellaneous and Special Purpose 117 Commercial Credit Insurance 118
Commercial Fishing Boats 119 Community Resort Associations 606
Community Service Agencies 121 Community Theaters 122
Computer Software Designers Errors and Omissions 123 Concrete Work Contractors 703
Condominium Directors and Officers Liability 124 Condominiums 125
Construction 762 Construction/Environmental Testing Laboratories 269
Consultants Professional Liability 127 Contractor Controlled Insurance Plan (CCIP) aka Contractor’s Wrap–Up 704
Contractors Design and Build (Project Managers) 128 Contractors Equipment Insurance 129
Contractors Pollution Liability 130 Contractual Bonus Insurance 675
Convenience Stores 638 Convention and Trade Show Insurance 132
Corporate or Employed Counsel Professional Liability 134 Cosmetic Manufacturers 135
Cosmetic Distributors 800 Country Club Insurance 136
Country Inns 682 County Clerks and Recorders Errors and Omissions 137
Courier and Messenger Services 138 Crane and Rigging Contractors 139
Crop Dusting and Spraying 141 Custom Harvesting Operations 143
Customized Vans 144 Customs Bonds 145
Customs Brokers and Freight Forwarders 142 Cyber Liability 362
Dance Schools 146 Dangerous Dog Liability Insurance 773
Day Care Centers – Adult 705 Day Care Centers – Children 149
Demolition Contractors Liability 150 Dental Hygienists Professional Liability 151
Dentists Professional Liability 152 Developmental Disabilities Facilities 435
Dieticians and Nutritionists Professional Liability 153 Difference in Conditions Insurance 154
Directors and Officers Liability 155 Directors and Officers Liability–Financial Institutions 156
Directors and Officers Liability–Nonprofit Organizations 157 Disc Jockey 807
Dive Shops/Instructors 579 Document Destruction Professional Liability 671
Dog Kennels 158 Drag Strip Liability (Spectators) 159
Dredging Contractors 642 Driveaway Collision Coverage 791
Driving Schools 160 Drug Testing Liability 581
Dump Trucks (Liability and Physical Damage) 161 Ear Piercing Liability 162
Earthquake and Earth Movement Insurance 163 E-cigarette Stores 813
Educational Institutions 662 Educators Professional Liability 164
Electric/Hybrid Vehicles 774 Electricians 706
Electronic Data Processing Equipment 707 Electronic Data Processors Errors and Omissions 708
Elevator Maintenance Contractors 165 Emergency Care Centers 810
Emergency Medical Technicians Errors and Omissions 166 Emergency Service Organizations 167
Employed Counsel Professional Liability 168 Employee Benefit Plans Liability 169
Employee Staffing Services 608 Employers Liability Coverage or Stop Gap Liability 636
Employment Agencies Errors and Omissions 170 Employment Temporary Services Agencies 172
Employment–Related Practices Liability 171 Engineers Professional aka Architects and Engineers Professional Liability 173
Environmental Consultants Errors and Omissions 174 Environmental Contractor Bonds 175
Environmental Impairment Liability 176 Environmental Remediation Contractors 609
Environmental Site Assessment 177 Equestrian Risks 178
Equipment and Tool Rental Services 179 Equipment Breakdown Coverage aka Boiler and Machinery Coverage 445
Equipment Leasing–Lessor Protection 180 Equity Protection Plan 764
Escrow Agents Errors and Omissions 181 Event Cancellation Insurance 483
Event Coordinators Errors and Omissions 709 Excavation Contractors 182
Excess and Surplus Lines Brokers and Managing General Agents Errors and Omissions 183 Excess FDIC Insurance 184
Excess Fidelity Bonds 185 Excess Flood Insurance 672
Excess Liability (Commercial) 186 Excess Liability (Over Self–insured Retention) 187
Excess Liability (Personal) 188 Excess Malpractice and Professional Liability 189
Excess Marine Liability 190 Excess Maritime Employers Liability 191
Excess Medical Stop Loss Coverage–Self–Insured Risks 192 Excess Property 652
Exercise and Physical Fitness Centers 193 Exterminators Liability 194
Farm Feed, Fertilizer, Seed and Supplies 711 Farm Implement Dealers 710
Farm Labor Contractors 775 Farmers Markets 712
Farms and Ranch Properties 196 Ferry Flight Insurance 763
Ferry Operators 792 Fertilizer Manufacturers 793
Film and TV Producers Errors and Omissions 197 Film and TV Producers Indemnity (Cast Insurance) 198
Film Schools Student Productions 769 Film/Movie Production Insurance 669
Financial Institutions 199 Financial Planners Errors and Omissions 200
Fine Arts Floaters (High Values) 201 Fire Protection Industry 574
Firearms Dealers and Distributors 202 Firefighters Accident, Death and Disability Coverage 203
Fireworks Displays–Contractors Risks 204 Fishing Contests 205
Flea Markets and Antique Shows 206 Flight Schools 803
Floor Laying and Other Floor Work Contractors 713 Food Rejection Insurance 207
Food Street Vendors 575 Food Trucks 814
Food–Borne Illness–Loss of Income 451 Force Majeure Insurance 208
Forced–placed Foreclosure Property Insurance 209 Foreign Film Production 770
Forensic and Expert Witness Errors and Omissions 210 Foresters Errors and Omissions 586
Foundries 714 Franchise Sponsored Mass Marketing Programs 211
Fraternal Organizations 610 Fumigators 212
Furriers Coverages 213 GAP Insurance 611
Garage Door Installation 815 Garage Liability–Repair and Service Operations 215
Garagekeepers Legal Liability 216 Garbage and Waste Haulers 217
General Contractor–Apartments and Condominiums 715 General Contractor–Industrial and Warehousing 716
General Contractor–Nonresidential Buildings – Not Industrial or Warehouse 717 Geothermal Energy Projects 220
Glass and Glazing Work Contractors 718 Global Medical Insurance 612
Golf Carts and Low Speed Vehicles (LSV) 776 Golf Course Architects 569
Golf Courses 222 Golf Driving Ranges 223
Grain Elevators 224 Green Building–Commercial 719
Green Building–Personal 720 Gun Collection Floaters 225
Gymnastics Liability 226 Hail Insurance on Growing Crops 227
Halfway Houses 228 Haunted Houses 229
Hazardous Industries Monoline Workers Compensation Insurance 649 Hazardous Material Haulers 230
Hazardous Waste Storage and Disposal Facilities 231 Health Foods Industry 576
Hearing Aid Service Errors and Omissions Liability 233 Heavy Construction Contractors 721
Helicopters 234 High Limit Disability 722
High Performance Boats 587 High Technology Exposures 235
High–Valued Commercial Property 653 High–Valued Personal Property 723
Highway and Street Construction Contractors 724 Historic Home Insurance 236
Hole–in–One Coverage 237 Home Business Insurance 725
Home Health Care Agencies 238 Home Inspection Errors and Omissions 621
Home Sellers Liability 588 Homebuilders Coverage 666
Homeowners Associations 589 Homeowners Policies–Low–Value and Nonstandard 239
Horse (Livestock) Major Medical and Surgery Insurance 243 Horse and Carriage Risks 240
Horse Breeders/Boarders 241 Horse Farms 242
Horticultural Risks 244 Hospice 777
Hospital Professional Liability 245 Hot Air Balloons (Liability and Physical Damage) 246
Hotels 247 Houseboats 248
Hunting and Fishing Clubs 250 Identity Theft Liability 778
Independent Pay Telephone Operators 627 Industrial Hygienists Errors and Omissions 251
Industry/Vendor Service Provider 726 Inland Marine 798
Installation Floaters – High–Value 252 Installment Sales Floater 253
Insurance Agents and Brokers Errors and Omissions 254 Insurance Company Financial Reporting 788
Insurance Company Professional Liability 255 Insurance Investigators Errors and Omissions 256
Intellectual Property Enforcement Coverage 257 Interior Designers Professional Liability 258
International Insurance 259 Internet Home (Web) Page Designers Errors and Omissions 614
Internet Liability 727 Internet Promotions 632
Investment Counselors Errors and Omissions 260 IRA or Keogh Plan Errors and Omissions s 262
Irrigation Designers Errors and Omissions 263 Janitorial Services 264
Jewelers Block 267 Jewelry and Fur Floaters (High Values) 268
Kart (Go–Kart) Liability 270 Kidnap/Ransom Insurance 271
Kidney Dialysis Centers 272 Labor Unions Errors and Omissions 273
Land Improvement Contractors 274 Land Surveyors Professional Liability 275
Landfill Closure Performance Bonds 276 Landfills (Sanitary) 277
Landscape Architects Professional Liability 278 Law Enforcement Officers Liability 279
Lawn Care Services 280 Lawyers Professional Liability 281
Lead Paint Contamination 282 Lead Paint Removal Contractors 283
Lead-based Paint Renovation, Repair and Painting Coverage 765 Legal Expense Insurance 284
Lenders Environmental Liability Insurance 285 Libraries 286
Limited Partnership Liability–Partnership Managers 288 Limousine Services 289
Liquefied Petroleum Gas Dealers 290 Liquor Dealers and Stores 291
Liquor Liability (Host Coverage) 292 Liquor Liability and Dram Shop Act Liability 293
Livestock Haulers 294 Livestock Mortality 295
Livestock–Auction Market Form 296 Livestock–Commercial Feedlot Reporting Form 297
Lobbyist 816 Locomotive Repair 802
Loggers Broad Form Property Damage Liability 298 Logging Operations 299
Long Haul Trucking Insurance 300 Managed Care Errors and Omissions 591
Manicurists Liability 301 Manufactured Home Haulers 302
Marina Operations 304 Marine Cargo Insurance 305
Marine Hull Insurance 306 Marine–related Professional Liability and Errors and Omissions Coverage 307
Marine War Risk 817 Maritime Liability 308
Marketing and Public Relations Firms Errors and Omissions 309 Marketing Consultants Errors and Omissions 310
Marriage and Family Counselors Professional Liability 311 Martial Arts Liability 312
Masonry, Stone Setting and Other Stonework Contractors 728 Massage Therapists Professional Liability 729
Material Handling Contractors 314 Media Liability 730
Media Promotions 634 Mediators/Arbitrators Errors and Omissions 315
Medical and Radiology Laboratories Professional Liability 316 Medical Billing Companies Errors and Omissions 615
Medical Diagnostic Centers Errors and Omissions 317 Medical Equipment Dealers 318
Medical Equipment Manufacturers 319 Medical Marijuana Crop Insurance 767
Medical Marijuana Dispensaries 766 Medical Personnel Service Agencies Professional Liability 320
Medical/Physical Rehabilitation Therapy 654 Medical Technology & Life Science Manufacturers and Distributors 786
Medical Tourism 785 MediSpas 677
Mental Health Clinics Professional Liability 321 Mergers and Acquisitions 640
Mexico Coverage 592 Micro Brewery/Brew Pubs 324
Military Housing Property Managers 674 Miniature Golf 323
Mining Operations and Equipment 326 Mobile Home Dealers–Physical Damage and Liability 327
Mobile Home Parks–Owners Liability 329 Mobilehome Personal Lines Coverage 731
Mortgage Bankers and Servicing Agents Errors and Omissions 331 Mortgage Brokers Errors and Omissions 593
Mortgage Impairment Insurance 332 Morticians Professional Liability 333
Motor Home Rentals 577 Motor Home/Travel Trailers (Commercial Use) 594
Motor Homes 334 Motor Scooter and Moped Rental Insurance 619
Motor Sports Liability 335 Motor Truck Cargo Insurance 336
Motorcycle Custom Manufacturing and Fabricating 667 Motorcycle Dealers 338
Motorcycle Insurance 337 Motorcycle Rental Insurance 629
Mountain Bikes/Dirt Bikes 339 Mountain Climbing/Mountaineering 340
Movie Boats 771 Moving Companies 578
Multiple Peril Crop Insurance 341 Municipal and Public Entities Liability 342
Museums 343 Musical Instrument Floaters 344
Musicians 779 Mutual Fund Managers Errors and Omissions 733
Mutual Funds Directors and Officers Coverage 732 Natural Gas Utilities 661
Negative Film Insurance 346 Nightclubs 660
Nonprofit Organizations 784 Notary Public Errors and Omissions 349
Nurse Practitioners 780 Nurse–Midwives Professional Liability 350
Nurseries 351 Nurses Professional Liability 352
Nursing Homes Professional Liability 353 Nutriceuticals 734
Oceanography Risks 354 Off–Course and Storage Coverage 630
Offshore Oil Drilling and Service Risks 355 Oil and Gas Deficiency Insurance–Guaranteed Performance 356
Oil Drilling Equipment 357 Oil Drilling Rigs and Well Servicing Equipment 358
Oil Jobbers/Petroleum Distributors 359 Oil Landmen and Lease Brokers Errors and Omissions 360
Oil Lease Property (Oil Field Equipment) 361 Oil Well Liability 363
Operators Extra Expense–Oil and Gas 364 Ophthalmologists Professional Liability 365
Opticians Professional Liability 366 Optometrists Professional Liability 367
Osteopaths Professional Liability 368 Outdoor Recreational Facilities 616
Outfitters and Guides Liability 369 Outpatient Clinics 370
Owner Controlled Insurance Plan (OCIP) aka Owner’s Wrap Up 735 Owners and Contractors Protective Liability (Monoline) 668
Paint Ball Game Centers 371 Paint Manufacturers 372
Painting–Exterior Contractors 737 Painting–Interior and Paper Hanging Contractors 736
Paralegal Professional 373 Paramedics Professional Liability 374
Parasailing Operators 375 Parking Garages and Parking Lots 376
Patent Infringement 378 Pawnshops 379
Pension Consultants' Professionals 738 Personal Trainers Professional Liability 595
Personal Watercraft 266 Pet Accident and Health Insurance 380
Pet Grooming Liability 382 Pet Mortality Insurance 381
Petrochemical Risks 383 Pharmacists Professional Liability (Employed) 384
Phone Card Promotions 633 Photographers Errors and Omissions 385
Physicians Assistants Professional Liability 386 Physicians Professional Liability 387
Physiotherapists Professional Liability 388 Pier and Dock Contractors 794
Pipeline Insurance 389 Pizza Delivery Services 390
Planners Professional Liability 391 Plastering, Drywall, Acoustical and Insulation Work Contractors 739
Plumbing, Heating and Air Conditioning Contractors 740 Podiatrists Professional Liability 580
Political Action Committees Liability 392 Political Risk Insurance 393
Pollution Cleanup Indemnity–Marine Operations 741 Pollution Cleanup Indemnity–Non–marine Operations 742
Polygraph Operators Professional Liability 395 Poultry Insurance 396
Power Distribution–Electric Utilities 670 Power/Pressure Washing Contractors 795
Precious Metal Dealers 397 Premium Finance Companies Errors and Omissions 398
Printers Errors and Omissions 399 Privacy Insurance 678
Private Corrections Industry 400 Prize Indemnification Insurance 401
Product Tampering Insurance 402 Product Warranty Inefficacy Coverage 403
Product Warranty Insurance 404 Products Liability–Hazardous or New Products 407
Products Liability–Retroactive 406 Products Recall Expense Insurance 408
Professional Athletes 409 Professional Employers Organizations (PEOs) 637
Professional Insurance Industry Organizations 676 Property Management Errors and Omissions 410
Prosthetic and Orthotic Patient Care Errors and Omissions 617 Protection and Indemnity Insurance (Marine) 411
Psychiatrists Professional Liability 412 Psychologists Professional Liability 413
Public Housing Authorities Liability 415 Public Officials Liability 416
Public Utilities Insurance 417 Publishers Liability 418
Quick Lubes 647 Race Car Drivers (AD&D Coverage) 419
Racetracks–Animals 743 Racetracks–Vehicles 744
Radiologists Professional Liability 420 Radon Mitigation Consultants and Contractors 421
Railroad Property and Liability Coverages 422 Railroad Protective Liability 423
Real Estate Agents Errors and Omissions 425 Recreational Clubs Liability 426
Recreational Trail Operators Liability 427 Recreational Vehicle Dealers 428
Recycling Centers 429 Registered Representatives (Mutual Funds) Errors and Omissions 430
Rehabilitation Projects 431 Research Organizations Errors and Omissions 582
Residential Remodeling Contractors 745 Residual Value Insurance–Autos, Equipment, etc. 432
Resorts 433 Restaurants 434
Retail Fireworks Sales 639 Rideshare Auto Insurance 818
Riding Academies/Hunt Clubs 437 Risk Retention Group and Purchase Group Programs 438
River and Harbor Craft 439 River Boat Gambling Casinos 583
Rock Concerts 440 Rodeos and Horse Shows 441
Roofing, Siding and Sheet Metal Work Contractors 442 Saddle Animal Liability 443
Sales Redemption Campaigns 446 Sand and Gravel Haulers 448
Scaffolding Risks 450 School Bus Contractors 781
Security Guard Services and Detective Agencies Liability 454 Seed Merchants Errors and Omissions 455
Self–Insurance Retention (SIR) Programs 457 Self–Storage Risks 456
Senior Housing 746 Sex Abuse/Molestation Liability 459
Ship Charterers Legal Liability 461 Ship Repairers Legal Liability 462
Shooting Range Liability (Trap and Skeet) 463 Shopping Centers–Malls 747
Shopping Centers–Strip 748 Short Line or Tourist Railroad Packages 465
Short Term Productions 772 Single Interest Insurance 466
Skateboard Parks Liability 468 Skating Centers (Roller and Ice) 469
Ski Operations 470 Slaughterhouses 806
Snowmobiles (Commercial and Rental) 472 Snow-removal Contractors 796
Snowmobiles (Personal Use) 473 Social Services Agencies 474
Social Workers and Welfare Workers Errors and Omissions 475 Soil Engineers Professional Liability 476
Solar Energy Products and Installers 477 Solar–Heated Risks 478
Space Industry Insurance 749 Special Events Liability 479
Special Risks Accident Insurance 481 Sperm Banks 819
Sport Fishing Boats 482 Sporting Events Sponsors 750
Sporting Goods and Equipment Manufacturers 485 Sports Camps 484
Sports Memorabilia (Baseball Cards, Etc.) 486 Sports Promotions Coverage 651
Stevedore Legal Liability 487 Stockbrokers Errors and Omissions 488
Stop Loss Excess Aggregate 489 Storage Tank Testing/Installation/Removal 490
Storage Tanks–Aboveground 491 Structural Steel Erection Contractors 751
Student Accident Insurance 492 Student Housing 681
Subsidized Housing 752 Substandard and Low–Valued Dwelling Fire Insurance 493
Substandard Businessowners Policy (BOP) 753 Substandard Crime Insurance 494
Substandard Fire (Commercial) 495 Substandard General Liability 496
Substandard Malpractice and Professional Liability 498 Substandard Package Policies 754
Summer Camps 499 Summer Recreational Activities 500
Supermarkets 501 Surety Bonds–Miscellaneous and Special Risks 502
Surety Bonds–Small Contractors 503 Surgeons Professional Liability 504
Swimming Pool Contractors 505 Talent Agencies Errors and Omissions 598
Tanning Salons Liability 507 Tattoo Parlors 585
Tattoo Removal Liability 599 Tax Preparers Errors and Omissions 508
Taxicabs 509 Team Sports Medical Accident Coverage 510
Tennis and Racquetball Centers (Indoor) 512 Terrazzo, Tile, Marble and Mosaic Work Contractors 755
Terrorism Coverage 756 Theater Groups 809
Third–Party Claims Administrators (TPA) Errors and Omissions 514 Third–Party Fidelity Coverage 515
Timeshare/Interval Ownership Operations 658 Tire Retreaders 516
Title Insurance Agents Errors and Omissions 517 Tour Operators Errors and Omissions 518
Tow Trucks Insurance 519 Trailer Manufacturers Product Liability 761
Transfer Agents Errors and Omissions 523 Transportation Brokers–Contingent Cargo Insurance 524
Travel Agents Errors and Omissions 525 Travel Trailers and Campers–Personal 526
Travel Trailer Rentals Insurance 600 Tree Service Liability 527
Trip Cancellation Insurance (TCI) 757 Truck Servicing Operations 801
Truckers Occupational Accident/Workers Compensation 529 Trucking Operations 758
Trust Department Errors and Omissions 530 Trustees and Fiduciaries Errors and Omissions–Pension, Welfare and Employee Benefit Funds 532
Umbrella Liability–Commercial 534 Umbrella Liability–Over Claims–Made Primary 535
Umbrella Liability–Personal 536 Unauthorized Computer Access Coverage 537
Underground Storage Tank (UST) Pollution Liability 538 Underwriting Guides and Checklists 789
United States Longshore and Harbor Workers Compensation Act 635 Unmanned Aerial Vehicle (UAV) 820
Used Car Dealers Insurance 540 Utility Systems Construction 759
Vacant Properties Insurance 542 Vanpool Operators 797
Vacation Income Property 680 Vacation Weather Cancellation Insurance 601
Valet Parking Services 782 Valued Business Interruption Insurance 543
Vending Machines Floater 544 Vessel Pollution 643
Veterinarians Professional Liability 545 Video Games/Arcade Centers 546
Video Rental Stores 547 War Risk Accident Insurance 548
Warehouse Operators Legal Liability 549 Water and Sewer Entities 783
Water Irrigation/Reclamation Districts Insurance 551 Water Parks Insurance 553
Water Ski Schools Liability 552 Water Sport Rentals 554
Water Well Contractors 657 Weather Insurance 555
Workers Compensation Self–Insurers Bonds 561 Wrap-Up 760
Wharfingers Legal Liability 556 Wind farms 805
Windstorm (Monoline) Coverage 644 Wineries 557
Winter Recreational Activities 558 Woodworking and Lumber Operations 559
Workers Compensation 684 Workers Compensation Excess Insurance 560
Yachts and Pleasure Boats 565 Youth Group Homes 618
Youth Outreach Programs 566 Youth Sports Programs–Accidental Death and Disability 567
Zoos and Zoological Societies 648

ONLY IMP ADVERTISERS' listings are FREE!

Please check only one - Program Administrator or Other Market Sources.

A SIGNED SIGNATURE PAGE MUST ACCOMPANY THIS QUESTIONNAIRE.

IMP NON-ADVERTISER LISTING CHARGES ARE:

(In U.S. Dollars)

Charges Based On Number Of Listings Checked

1-5   Listings   $290   (minimum charges)   101-199   Listings   $1,435
6-15   Listings   $395       200-299   Listings   $1,590
16-30   Listings   $580       300-349   Listings   $1,790
31-50   Listings   $725       350-399   Listings   $1,890
51-75   Listings   $905       400-500   Listings   $1,965
76-100   Listings   $1,030       500 Plus   Listings   $2,890

CHARGES INCLUDE PUBLICATION IN PRINT AND INTERNET VERSIONS

  WE HAVE CHECKED CATEGORIES FOR A TOTAL OF $
 
 
 

PLEASE RETAIN A COPY FOR YOUR RECORDS

A signature verifying the choice of listings and authorizing the charges is required.

I authorize the publishers of The Insurance Marketplace® to publish our listings and if not prepaid with this questionnaire, agree to submit a listing payment in accord with the schedule above.

     
  Type name and title (Officer of Company)   Company  
     
  Signature   Mailing Address  
       
      City / State / Zip  

For your coverages to be included in the 2017 Edition of The Insurance Marketplace®, we must have your questionnaire by August 26, 2016!

Please return to: The Insurance Marketplace

The Rough Notes Company, Inc., P.O. Box 1990, Carmel, IN 46032-4990

Phone: 800-428-4384 or Fax: 317-816-1000 Email: carolynp@roughnotes.com

DEADLINE AUGUST 26TH, 2016

PLEASE RETAIN A COPY FOR YOUR RECORDS

ANY UPDATES TO PREVIOUSLY RETURNED QUESTIONNAIRES MUST BE RECEIVED BY 8/26/2016