Forms Library

Here you can find the majority of the forms we use in our office to quote new business, initiate policy changes, and request certain pieces of information.

Applications for Insurance

Cyber & Data Breach Insurance for Educational Institutions

Cyber & Data Breach Insurance for Educational Institutions

CHUBB Insurance Cyber and Date Breach Response Coverage Insurance Application. Used for Educational Programs and Educational Institutions. Not for general business use.

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Directors and Officers Insurance Application Form

Directors and Officers Insurance Application Form

Long Form including D & O, Employment Practices, Cyber, and many more selections of coverage.

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Business Classification References

PA SWIF Codes and Rates

PA SWIF Codes and Rates

SWIF Publishes rates and releases them to the public. You can find a general classification guide here.

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PA SWIF Codes and Rates By Classification

PA SWIF Codes and Rates By Classification

Reference Guide by General Classification

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PA Work Comp Class Reference by Classification

PA Work Comp Class Reference by Classification

PCRB PA Class Search by Classification

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PA Workers Compensation Reference Manual

PA Workers Compensation Reference Manual

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General Liability Applications

Cannabis and Marijuana Insurance Liability Insurance Coverage Supplement

Cannabis and Marijuana Insurance Liability Insurance Coverage Supplement

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Workers Compensation Applications

Officer Declaration and Exclusion Form for Pennslyvania Workers Compensation Insurance

Officer Declaration and Exclusion Form for Pennslyvania Workers Compensation Insurance

If you own a S Corp C Corp or are the executive director of a non profit you must decide whether or not you would like to be covered under your company workers compensation coverage.

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PA Work Comp Coverage Election Form for LLCs Sole Proprietors Partnerships and Joint Ventures

PA Work Comp Coverage Election Form for LLCs Sole Proprietors Partnerships and Joint Ventures

Need to get covered under workers compensation? And you are an LLC, Sole Proprietor, or Partnership? Use this form here.

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Workers Compensation Insurance Application KELLY INSURANCE GROUP

Workers Compensation Insurance Application KELLY INSURANCE GROUP

If you would like to receive a workers compensation quote, it could help to get the Workers Compensation Insurance Application completed. You don’t need to fill in every minute detail, but the more information you input, the quicker the process will be.

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