Willis Programs | Resources | Forms & Applications for our Niche Insurance Programs

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Resource Center

The PUMP Programs

	Gas Pump Eligibility
	Gas Pump Submission Questionnaire
	Gas Pump Supplemental Questionnaire
	Bulk Lubes Supplemental Questionnaire
	Fuel Oil Dealers Supplemental Questionnaire
	Fuel Oil Eligibility
	LP Gas Addendum
	Liquor Supplemental Questionnaire
	Tractor Trailer Addendum
	Convenience Store Addendum
	General Liability Classification Supplement

RecycleGuard

	RecycleGuard Submission Checklist
	RecycleGuard Supplemental Questionnaire
	Certified Destruction Services
	Non-Certified Destruction Services
	Pollution Legal Liability Application
	Supplemental - Auto Dismantlers
	Supplemental - Automobile Shredding Operations
	Supplemental - Rubber
	RecycleGuard Risk Management Services

ResortGuard

	Community Association Comprehensive Profile
	Destination Resorts Comprehensive Profile
	For Profit Directors and Officers (D&O) Application
	Non Profit Directors and Officers (D&O) Application
	Resort Condos Comprehensive Profile
	ResortGuard Risk Management Services

RinkGuard

	Special Activities - Climbing Walls Application
	Special Activities - Concerts Application
	Special Activities - Daycare Application
	Special Activities - Fireworks Application
	Supplemental Application

ShredderGuard

	Document Destruction Professional Services Endorsement
	Document Destruction Services - Non NAID Certified
	Document Destruction Services Application
	General Terms and Conditions
	Miscellaneous Professional Liability Coverage

SocialServicesGuard

	Drug and Alcohol Treatment Program Application
	SocialServicesGuard Application
	Adult Day Care Application
	Adult Day Care Abuse Supplemental Application
	Adult Day Care Medication Management Protocols
	Adult Day Care Automobile Questionnaire
	Adult Day Care Property Supplemental Application

UtilitySure

	Supplemental Application
	Electric Co. Supplemental Application
	Waterworks Supplemental App

WasteHaulerGuard

	Supplemental Application
	Environmental Impairment Liability Application

WellGuard

	Supplemental Application
	Submission Essential Check List

WorkCompGuard

	Supplemental Questionnaire

Resource Center - Forms and Applications

Click on any of the links below to download the application or form. (Please note Adobe Reader 8 or greater is required for saving typed data in some of the forms. Please click the Adobe icon below to upgrade).

Willis Programs

	Programs Placemat

AutoServiceGuard

	AutoServiceGuard Supplemental Application

CAR-PAC

	CAR-PAC Supplemental Application
	AVEMCO Application for Employment Related Practices Liability Insurance
	CAR-PAC Garage Exposure Employee Information
	CAR-PAC Garage Exposure Employee Information
	Corporate Identity Protection
	Dealers Inventory Protection Program
	The Hail Exchange Dealer Request Form

DealerGuard

	Surplus Lines Affidavit
	Vehicle Inventory Protection Application
	Hail Exchange Application
	Spot Declaration

EquipGuard

	EquipGuard Supplemental Application
	EquipGuard Aerial Device

HomeCareGuard

	Application for Insurance Coverages for Health Care Organizations
	Renewal Application for Insurance Coverages for Health Care Organizations
	Supplemental Staffing Short Form Questionnaire
	Home Health Agency Short Form Questionnaire

HealthServicesGuard

	Non-Surgery Center Application
	Surgery Center Application

LawyerGuard

Applications and forms for LawyerGuard are located on a separate page. Please click on the link below to access LawyerGuard's forms and applications.

LawyerGuard Resource Page

LimousineGuard

	Limo Operators Supplemental Application
	Vehicle List

MedEquipGuard

	New Business Application
	Renewal Application
	Durable Medical Equipment Short Form

MetalWorkingGuard

	Supplemental Questionnaire for MetalWorkingGuard & PlasticsGuard Programs
	Metal Finishing Supplemental Questionnaire

PlasticsGuard

	Supplemental Questionnaire for MetalWorkingGuard & PlasticsGuard Programs