World Wide Staffing Insurance Applications

For the following staffing insurance policies, please use the applications below:

• Professional Liability
• General Liability
• Abusive Acts
• Employee Benefits Liability
• Employment Practices Liability
• Hired and Non-Owned Auto
• Stop Gap Liability
• Crime

Please use the state-appropriate applications below:

• World Wide Staffing Industry Insurance Application.pdf
  (For all states including District of Columbia, except for Florida and Maine)

• • Florida and Maine Staffing Industry Insurance Application.pdf
    (For Florida and Maine)

Philadelphia Insurance Companies TEMPORARY STAFFING AGENCY APPLICATIONS

• TEMPORARY STAFFING AGENCY New Business Application.pdf
  (For all states, including District of Columbia, except for Massachusetts)
• TEMPORARY STAFFING AGENCY New Business Application-MA.pdf
• TEMPORARY STAFFING AGENCY Renewal Application.pdf
  (For all states, including District of Columbia, except for Massachusetts)
• TEMPORARY STAFFING AGENCY Renewal Application-MA.pdf

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• Fraudulent Impersonation Supplemental Questionaire (Social Engineering)

For World Wide Security and Privacy Liability (Cyber) insurance, please use the state –appropriate applications below:

• FL and ME-pdf
• ID-pdf
• KS-pdf
• MO-pdf
• NC-pdf
• NJ-pdf
• SD-pdf
• VT-pdf

For All Other states (except -AK, GA, ND, WA ) use the following application–

• Other States-pdf

For- AK, GA, ND, WA -please contact your state-assigned Account Manager or Underwriter at WW           (Pending NY)

For Owned Auto Liability insurance, please use the application below or an ACORD Form Application (accepted by all states):

• Auto Liability Coverage Application.pdf

For Property and Inland Marine insurance, please use the application below or an ACORD Form Application (accepted by all states):

• Commercial Property Coverage Application.pdf

For Direct Hire/Executive Search & Recruitment/Retained Search Liability insurance- please use applications below:

-Professional Liability/Employment Related Practices– (Please use the state-appropriate applications below):

• U-SI-152-C CW 0914 Application.pdf
  (For all states including District of Columbia, except for Florida and Maine)
• U-SI-152-C MU 0914 Application.pdf
  (For Florida and Maine)

-Office Package (GL, EB, Stop Gap, HNOA, Crime)

• Package Policy Application.pdf

-Property Insurance

• Commercial Property Coverage Application.pdf

For the following policies, please use an ACORD Form Application (accepted by all states); attach app where indicated, or contact your state–assigned Account Manager or Underwriter at World Wide.

• Umbrella Liability
• Workers’ Compensation

*For Workers’ Compensation policy, in addition to the ACORD Form Application please also use the World Wide Specialty Workers’ Compensation Temporary Staffing Program – Supplemental Application below.

• World Wide Specialty Workers’ Compensation Temporary Staffing Program – Supplemental Application

For the following policies, contact your Account Manager at World Wide for Applications.

• D&O Liability
• Fiduciary Liability