Accountants Professional Liability Application

Accountants Professional Liability Application

Contact Information

Firm Information

In the last 5 years...

Current Coverage

Areas of Practice

Please indicate below the percentage of gross income generated from each area of practice in the past year.

Claims History Within The Last 5 Years

By submitting this indication sheet, I hereby acknowledge that this indication sheet is intended for information collection purposes only, and submission does not guarantee that coverage will be placed for my firm and does not obligate my firm to purchase coverage. By submitting this indication sheet, I further agree that Oswald Companies shall be the exclusive Broker of Record (BOR) with respect to any/all quotes I may receive based upon this application.

Please contact Kim Ferenchak with any questions (p. 216-367-4942;