Our complete list of available applications is below. Please contact us if you do not see the application you need or need assistance completing one. Download, print, and email or fax an application to us at or 661-266-9391. Applications open in Adobe PDF format.

ApplicationDescriptionFormats Available
COVID-19 Abatement & Cleaning Questionnaire
Contractor’s Pollution Liability Application
(Chubb Westchester)
Environmental Insurance-ContractorsPDF
Contractor’s Pollution Liability Application
Environmental Insurance-ContractorsPDF
Contractor’s QuestionnaireGeneral Liability InsurancePDF
CPL Quick Indication FormCPL EnvironmentalPDF Word
Crane QuestionnaireCrane InsurancePDF
Contractors and Consultants ApplicationEnvironmental InsurancePDF
Fire Suppression Supplemental ApplicationFire SuppressionPDF
Hazardous Transporters Commercial Auto App
(Chubb Westchester)
Hazardous Waste TransportersPDF
Premises Pollution Liability Application
(Chubb Westchester)
GL, Pollution, Excess CasualtyPDF
Restoration Contractors Pollution Liability Application
(Chubb Westchester)
Site PollutionPDF
Facilities Pollution Application
Site PollutionWord
Environmental Insurance Application
Environmental InsurancePDF
Enivronmental Service Application
(C&S Specialty)
Environmental InsurancePDF
Commercial DivingPDF
Contractors Supplemental FormConstructionPDF
Crane Milwright and RiggersConstructionPDF
Energy ConsultantsEnergy RisksPDF
Energy Employee BenefitsEnergy RisksPDF
Energy ExcessEnergy RisksPDF
Energy HaulingEnergy RisksPDF
Energy Hired AutoEnergy RisksPDF
Energy PipelineEnergy RisksPDF
Energy General ApplicationEnergy RisksPDF
General MiningMining RisksPDF
Lease OperatiorMining Risks
Maritime Employers LiabilityPDF
Mine Contract LaborMining RisksPDF
Owners and Contractors Protective LiabilityMining RisksPDF
Specific MineMining RisksPDF
Prep Plant Supp.PDF
Life Sciences ApplicationPDF
Clinical Trials ApplicationPDF
Medical Equipment ApplicationPDF
Medical Laboratories ApplicationPDF
Medical Marijuana ApplicationPDF
Medical Products ApplicationPDF
Tissue Banks Application
Agricultural Environmental Insurance ApplicationPDF
Manufacturers Products Pollution ApplicationPDF
Environmental Products Pollution ApplicationPDF
Environmental Energy ApplicationPDF
Stone/Aggregate Quarry Program Supplemental ApplicationMining RisksPDF
Mining Auto Supplemental ApplicationMining RisksPDF
Demolition & Blasting Contractor ApplicationMining Risks PDF
Drilling Contractor GL Supplemental ApplicationMining RisksPDF
GL Hired & Nonowned Auto Supplemental ApplicationMining RisksPDF
Machinists & Fabricators Supplemental ApplicationMining Risks PDF
GL Hired & Nonowned Auto Supplemental ApplicationMining RisksPDF
Mining Supplemental ApplicationMining RisksPDF
Off Road Coal Hauler GL Supplemental ApplicationMining Risks PDF
Service Contractor GL Supplemental ApplicationMining RisksPDF
Bailee’s Coverage ApplicationPDF Word
Architects and Engineers Professional LiabilityPDF
Real Estate Developers and Owners Professional LiabilityPDF
Contractors Professional LiabilityPDF
Architects, Engineers, and Construction Managers Professional LiabilityPDF
Products Pollution ApplicationPDF
Environmental Pollution & Casualty Application (Manufacturers and Distributors)PDF
Hired and Non-Owned Auto SupplementalPDF