Public Sector Insurance Services - Applications

Please print and complete the following applications and ask your agent or broker to submit to the underwriting contact in your territory.

Information on agent/broker member programs is available at the ACORD website.

Municipalities

Public Sector Services Insurance Application

Public Sector Services Insurance Multi-Use Application (all states EXCEPT MT and NC)  

Public Sector Abuse or Molestation Coverage Additional Information Request

Public Sector Services Utility Additional Information Request

Healthcare Professionals Additional Information Request

Dams/Levee/Dike/Canal/Flood Wall Additional Information Request

Recreational Activities Additional Information Request

Unmanned Aircraft (Drone) Liability Additional information Request

Workers Compensation Additional Information Request 

Anaerobic Digestion/Landfill Gas Facilities Additional Information Request

Biomass Power Facilities Additional Information Request

Stand-alone public entities

Transit Application 

Educational Institutions Additional Information Request

Indian Nations Supplemental Application

Professional liability

Law Enforcement Liability Additional Information Request

Public Entity Management Liability Additional Information Request

Public Entity Employment-Related Practices Liability Additional Information Request

Resources

Public entity contacts

Business income worksheets for public entities

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