Environmental Pollution Group

Forms

Print out our insurance application or see the actual insuring language in use by EPG. Completed applications can be scanned, attached to an email and sent to any underwriter on our Contact page, or faxed to (203) 730-8863.

Applications
Insuring Forms

Applications

All Forms can be completed and saved in Adobe or other PDF readers.

Vessel Pollution Application
COFR Application
Storage Tank Liability - ASTs & USTs
Site Pollution Application
Contractors Pollution Application
Environmental Energy
Product Manufacturers Pollution Application
Transportation Pollution Liability

Insuring Forms

LSW 1220 - London U.S. Vessel Pollution Insurance Policy
LSW 176A - Pollution Hazard Policy
Due to the number of markets and differing insuring forms used, non-marine insuring forms are available upon request and will be based upon the insurer selected during the placement process.

(203) 730-8833

24 Hour Claims Line

Forms

Applications

Insuring Forms