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
Adult Day Care       PDF
Agriculture Application (Acord)       PDF
Agriculture Liability Section (Acord)       PDF
Agriculture Property Section (Acord)       PDF
Agriculture Property Section - Scheduled and Unscheduled Farm Personal Property (Acord)       PDF
Alarm Installers       PDF
Amusement Centers/Devices     Word PDF
Animal Grooming     Word PDF
Architects & Engineers – Small Firm       PDF
Architects, Engineers & Construction Managers – Miscellaneous       PDF
Artisan Contractors Supplemental - Scottsdale       PDF
Beauty Salons/Barber Shops       PDF
Builder's Risk- USLI (Property & GL)       PDF
Builder's Risk- Markel (Package)       PDF
Builder's Risk- Scottsdale (Inland Marine Form)       PDF
Builder's Risk- Lexington (Homeowners Form)       PDF
Caterers – Scottsdale       PDF
Club Liability       PDF
Collections       PDF
Commercial Equine Liability Application (Markel)       PDF
Commercial Umbrella       PDF
Committee for Sale – Foreclosure       PDF
Community Association Crime Coverage       PDF
Comprehensive Personal Liability (Nautilus)       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
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
Demolition – Wrecking of Building (Per Job Basis)       PDF
Detective Agencies       PDF
Directors and Officers – Community Association       PDF
Directors and Officers Liability – Nonprofit       PDF
Directors and Officers Liability – For Profit     Word PDF
Dwelling Fire Application – Scottsdale       PDF
Emergency and Non-Emergency Medical Transport – EMTs, Ambulance Drivers or Attendants       PDF
Employment Practices Liability       PDF
Equine Liability Supplement (Acord)       PDF
Excavators and Grading of Land       PDF
Excess Flood Insurance     Word PDF
Excess Flood Insurance Application - Lexington       PDF
Exercise and Health Studios & Personal Trainers       PDF
Exterminators/Pest Control       PDF
Foreclosure/Eviction/Clean-Up Program Application (Scottsdale)       PDF
General Contractors (Markel)       PDF
General Contractors (Western World)       PDF
General Contractors Renewal Questionnaire (Western World)       PDF
 Habitational Supplemental Application (Scottsdale)       PDF
Halfway House – Shelters       PDF
Hartford Steam Boiler- Equipment Breakdown       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 (Lexington)       PDF
ICAT Supplemental Property Application       PDF
Insurance Agents & Brokers – Professional Liability       PDF
Janitorial Program       PDF
Landowner's Program       PDF
Landscape Gardening       PDF
Lexington – Homeowners Acord Supplemental       PDF
Lexington – Homeowners – Corporation, LLC, or LLP       PDF
Lexington – Log Home Questionnaire     Word  
Lexington – Modified Functional Replacement Cost Acknowledgement     Word  
Lexington – Older Home Questionnaire       PDF
Lexington – Personal Inland Marine       PDF
Lexington – Supplemental Heating Questionnaire     Word
Lexington – Unprotected Rating Questionnaire       PDF
Liquor Liability (ACE)       PDF
Liquor Liability (Markel)       PDF
Liquor Liability (USLI)       PDF
Liquor Liability (Scottsdale)       PDF
Liquor Liability -- Off-Premises Supplement       PDF
Logging & Lumbering Supplemental       PDF
Management Consultant     Word PDF
Martial Arts Studio- Scottsdale       PDF
Martial Arts Studio- Western World       PDF
Medical Equipment - Sales/Rental/Lease Liability       PDF
Medical Providers       PDF
Motor Truck Cargo     Word PDF
Personal Umbrella (Acord)       PDF
Personal Umbrella (Nautilus)       PDF
Personal Umbrella (USLI)       PDF
Pet Pak     Word PDF
Physician's Opinion Statement – Driver Fitness       PDF
Private Horse Owner Application (Markel)       PDF
Product Liability / Discontinued Products       PDF
Professional – Miscellaneous       PDF
Property Manager E&O       PDF
Property Preservation Contractors       PDF
Real Estate Agent E&O       PDF
Real Estate Property Managers Supplemental (Western World)       PDF
Remodelers Supplemental (Western World)       PDF
Restaurants (Scottsdale)       PDF
Restaurants (USLI)       PDF
Restaurant Supplemental (HIIG)       PDF
Roofing Contractors       PDF
Schools       PDF
Security Guards & Related Operations       PDF
Snow & Ice Removal Contractors Supplemental Application- Parking lots, Driveways & Sidewalks Only- Western World       PDF
Solid Fuel Questionnaire (Acord)       PDF
Special Event Liability     Word PDF
Special Event Liability (General Liability & Liquor Liability)       PDF
Specified Professions — Professional Liability     Word PDF
Sports Camps/Clinics/Leagues       PDF
Stand-Alone Abuse and Molestation Application       PDF
Statement of Values     Excel
Swimming Pool Contractors, Dealers & Installers       PDF
Swimming Pool Maintenance & Management       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
Vacant Building       PDF
Vacant Building (Markel)       PDF
Watercraft – Excess Liability       PDF
Welding, Brazing & Cutting Supplemental       PDF
Wood/Coal/Pellet Stove Supplemental       PDF
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