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FLEXI PLUS FIVE RENEWAL APPLICATION NOT …

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FLEXI plus five RENEWAL APPLICATION NOT-FOR-PROFIT ORGANIZATION DIRECTORS AND OFFICERS LIABILITY INSURANCE EMPLOYMENT PRACTICES LIABILITY INSURANCE FIDUCIARY LIABILITY INSURANCE WORKPLACE VIOLENCE COVERAGE INTERNET LIABILITY INSURANCE THIS IS AN APPLICATION FOR A CLAIMS MADE POLICY PLEASE READ YOUR POLICY CAREFULLY Instructions: Whenever used in this APPLICATION the term Applicant shall mean the Parent Organization and its wholly-owned/controlled subsidiaries. The Applicant is required to complete Sections 1, 2, and 7. The Applicant should complete other applicable Section(s) for which coverage is desired. (See chart below) Please include all requested underwriting information and attachments.

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