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ACE Management Indemnity Package Application
I. General Information
1. Name
Years of Operations
2. Address
City
State
Zip
3. Natures of Operations
Applicants Website
Primary SIC Code
Coverage Sections Requested:
D&O
Employment Practices Liability
Fiduciary Liability
Crime
4. Has the Applicant in the past 18 months been involved with any actual, negotiated or attempted merger, acquisition or divestment?
Yes
No
4a. Please provide details for your answer to question 4
5. Does the Applicant contemplate transacting any mergers or acquisitions that would involve more than 50% of the total assets of the Applicant in the next 12 months?
Yes
No
5a. Please provide details for your answer to question 5
6. Does the Applicant own more than (3) subsidiaries?
Yes
No
6a. Please provide details for your answer to question 6
7. Are there any subsidiaries with operations that are unrelated to the primary business of the Applicant?
Yes
No
7a. Please provide details for your answer to question 7
8. Are there any foreign operations that are unrelated to the primary business of the Applicant?
Yes
No
8a. Please provide details for your answer to question 8
If you are human, leave this field blank.
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