Connecticut Underwriters

The Northeast's Leading Independent Excess and Surplus Lines Broker


Below are policy applications that are available for you to download or print. Many applications are available in Microsoft Word format; all are available in Adobe PDF format.

Affidavits Terrorism E&O and Nurses Policy Forms Automotive

All applications can either be faxed to Connecticut Underwriters or emailed to

A | B | C | D | E | F | G | H | I | J | L | M | O | P | R | S | T | U | V | W

Affidavits | Errors & Omissions | Nursing | Privacy & Security Coverage | Terrorism | W9 | Vermont Fee Acknowledgement | Additional Insured Questionnaire
Unprotected Rating Questionnaire

CUI Homeowners Word PDF
Acord Supplemental Application - Lexington       PDF
Adult Day Care       PDF
Alarm Installers     Word PDF
Ambulance Attendants, Drivers       PDF
Amusement Centers/Devices     Word PDF
Animal Exclusion Endorsement - Lexington       PDF
Animal Grooming     Word PDF
Architects & Engineers – Small Firm       PDF
Architects & Engineers – Miscellaneous       PDF
Artisan Contractors Supplemental - Scottsdale       PDF
Beauty Salons/Barber Shops       PDF
Bed & Breakfast Application       PDF
Builder's Risk       PDF
Builder's Risk Supplemental Application - Lexington     Word  
Club Liability       PDF
Collections       PDF
Commercial Umbrella       PDF
Committee for Sale – Foreclosure       PDF
Community Association Crime Coverage       PDF
Condominium Associations – Residential     Word PDF
Consultant — Miscellaneous E&O       PDF
Contractors – Artisans M.I.C.K.     PDF
Contractors Equipment     Word PDF
Contractors Supplemental – Markel       PDF
Convenience, Delicatessen & Grocery Stores       PDF
Corporate Named Insured Supplemental Questionnaire     Word  
Coporation, LLC or LLP Questionnaire - Lexington       PDF
Counseling/Therapy Centers & Individual Professionals (Prof./GL)       PDF
Dam Questionnaire     Word PDF
Dance Studios       PDF
Day Care Center       PDF
Day Spa       PDF
Demolition Contractor       PDF
Designated Operator Exclusion       PDF
Detective Agencies     Word PDF
Directors and Officers – Community Association       PDF
Directors and Officers Liability – Nonprofit       PDF
Directors and Officers Liability – For Profit     Word PDF
Emergency Care Services – EMTs       PDF
Employment Practices Liability     Word PDF
Excavators and Grading of Land     Word PDF
Excess Flood Insurance     Word PDF
Excess Flood Insurance Application - Lexington       PDF
Exercise and Health Studios & Personal Trainers       PDF
Exterminators/Pest Control     Word PDF
Farmowners Application –CT and Mass       PDF
Foreclosure/Eviction/Clean-Up Program Application (Scottsdale)     Word PDF
General Contractors (Nautilus)     Word PDF
General Contractors (Western World)       PDF
General Contractors Renewal Questionnaire (Western World)       PDF
General Contractors (Scottsdale)     Word PDF
General Contractors (USLI)       PDF
Habitational (Scottsdale)     Word PDF
Halfway House – Shelters       PDF
Health Care – Counseling & Therapy Centers & Individual Professionals (Prof./GL)       PDF
Health Care – Home Health/Nurse Registries       PDF
Health Care – Home Health/Nurse Registries – Renewal Questionnaire       PDF
Hired/Non-Owned Auto Coverage     Word PDF
Hole-in-One     Word PDF
Home Inspectors E&O       PDF
Homemakers Application – Personal Care Assistant (Non-Nursing)     Word PDF
Homeowners   CUI Homeowners   PDF
Homeowners Association       PDF
Homeowners Dwelling Program Application       PDF
Homeowners Dwelling Program Application - Lexington       PDF
ICAT Supplemental Property Application       PDF
Insurance Agents & Brokers – Professional Liability       PDF
Janitorial Program     Word PDF
Jewelry (Personal)       PDF
Landowner's Program     Word PDF
Landscape Gardening     Word PDF
Liquor Liability (Acord)     Word PDF
Liquor Liability (USLI)       PDF
Liquor Liability (Nautilus)       PDF
Liquor Liability (Scottsdale)     Word  
Liquor Liability -- Off-Premises Supplement       PDF
Log Home Questionnaire - Lexington     Word  
Management Consultant     Word PDF
Martial Arts Studio       PDF
Medical Equipment - Sales/Rental/Lease Liability       PDF
Medical Providers       PDF
Modified Functional Replacement Cost Acknowledgement     Word  
Motor Truck Cargo     Word PDF
Older Home Questionnaire - Lexington       PDF
Personal Inland Marine Application - Lexington       PDF
Personal Umbrella (Nautilus)       PDF
Personal Liability Application (Nautilus)       PDF
Pet Pak     Word PDF
Physician's Opinion Statement – Driver Fitness       PDF
Product Liability / Discontinued Products       PDF
Professional – Miscellaneous       PDF
Property Manager E&O       PDF
Real Estate Agent E&O       PDF
Real Estate Property Managers Supplemental (Western World)       PDF
Restaurants (Scottsdale)     Word PDF
Restaurants (USLI)       PDF
Restaurant Supplemental (Axiom)       PDF
Roofing Contractors       PDF
Roofers Questionnaire       PDF
Schools       PDF
Security Guards & Related Operations       PDF
Snow & Ice Removal Contractors Supplemental Application       PDF
Special Event Liability (Scottsdale)     Word PDF
Special Event Liability (USLI)       PDF
Special Event Liability (Western World)       PDF
Specified Professions — Professional Liability     Word PDF
Sports Camps/Clinics/Leagues       PDF
Stand-Alone Abuse and Molestation Application       PDF
Statement of Values     Excel
Supplemental Heating Questionnaire - Lexington     Word
Swimming Pool Contractors, Dealers & Installers       PDF
Swimming Pool Maintenance & Management     Word PDF
Tanning Salons       PDF
Technology — Professional Liability       PDF
Technology E&O Copyright/Trademark Supplemental       PDF
Tree Trimming, Landscape Gardening, Lawn Care Services & Snow Removal       PDF
Unprotected Rating Questionnaire     Word  
Unprotected Rating Questionnaire - Lexington       PDF
Vacant Building Package – Lloyds       PDF
Vacant Building Package – Scottsdale       PDF
Vacant Building Package – USLI       PDF
Watercraft – Supplemental with Personal Umbrella       PDF
Welding, Brazing & Cutting Supplemental       PDF
Wood/Coal/Pellet Stove Supplemental       PDF
Wrecking of Building       PDF
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