About MVGA Applications

Most accounts can be quoted with the completion of Acord applications only. There are times however when additional information is needed in order to review the account for quoting. Many of the risks that require additional applications are specialized accounts in which we have secured specialized programs and the additional information is extremely important in determining proper price and risk selection. Even though an application or supplemental application may be available for certain classes of business, we always recommend that you provide us with a properly completed Acord application.

Acord Applications

ACORD Forms are the primary applications used the insurance industry. The standardization that ACORD has created increases the effectiveness and ease of completing an insurance transaction for you and your customers. We ask that you complete the proper ACORD Form for each submission you send to us.

For more information, please visit: www.acord.org

Appointment Applications
Thank you for your interest in becoming one of our appointed agencies. We offer access to many of the best carriers in the industry and provide unmatched service with no volume requirements. Our staff is dedicated to helping you and your staff succeed in writing profitable accounts. We take a more personal approach than other MGA’s and we believe you will enjoy the difference.

Appointment Documents (Please use the following):

Appointment Packet – DOC | PDF

Branch Supplement (only needed when multiple offices exist)  – DOCX | PDF

W-9 Form – Required with appointment packet – PDF

Commercial Transportation Applications

The commercial lines department at MVGA is staffed with only the best underwriters in the business. Their knowledge and understanding of the unique risks you are trying to write makes them the perfect resource to your agency.

Our most popular classes are non-emergency medical transport, trucking (under 500 miles), log trucks, dump trucks and contractors.<br
We look for risks that have been in business for at least 2 years with profitable loss history and good experienced drivers.</br

Available applications. Note: The Word versions are fillable.

Commercial Auto App – DOC | PDF

Motor Truck Cargo App – DOCX | PDF

Supplementals (Please use in addition to the application chosen above):

Auto Mechanical Inspection Report Form (Completed by licensed mechanic) – DOCX| PDF

Driver Employment History Form – Public Auto – DOCX| PDF

Driver Schedule (Use if driver list does not fit on main application)DOCX| PDF

For Hire Truckers GL Supplemental – DOCX| PDF

Hired and Non-owned Auto Supplemental – DOCX| PDF

Non-Emergency Medical Transportation Supplemental – DOCX| PDF

Public Auto Supplemental – DOCX | PDF

Vehicle Schedule (Use if vehicle list does not fit on main application) – DOCX | PDF

Dealers And Garage Applications
Applications and forms are provided for your convenience. Using our applications and forms greatly enhance our ability to serve you and your clients. Our applications and forms can be viewed using either Microsoft Word or Adobe Acrobat Reader. To download, simply click the icon that corresponds to the file type you wish to view.

Available applications. Note: The Word (Doc/Docx) versions are fillable.

Auto Service Risks Supplement – DOCX | PDF

Garage and Auto Dealer Application – XLS |PDF

Specialty Vehicle Supplement – PDF

Valet And Parking Lot Supplement – PDF

General Liability And Property Applications
Applications and forms are provided for your convenience. Using our applications and forms greatly enhance our ability to serve you and your clients. Our applications and forms can be viewed using Adobe Acrobat Reader. To download, simply click the PDF icon that corresponds to the file you wish to view.

Available applications. Note: The Word (doc/docx) versions are fillable. Please select from one of the icons:

Additional Insured Supplement – DOCX |PDF

Adult Day Care Supplement – DOCX |PDF

Alarm Installation Supplement – DOCX |PDF

Amusement Supplement – DOCX |PDF

Animal Services Supplement – DOCX |PDF

Artisan/Trade Contractors Supplement – DOCX |PDF

Artisan/Trade Contractors Supplement – Renewal App – DOCX |PDF

Auto Service Risks Supplement – DOCX |PDF

Bars-Restaurants-Taverns Supplement – DOCX |PDF

Beauty-Barber Shop Supplement – DOCX |PDF

Blasting Contractors Supplement – DOCX |PDF

Builders Risk Supplement – DOCX | PDF

Caterers and Halls Supplement – DOCX |PDF

Climbing Wall Supplement – DOCX | PDF

Clubs Supplement – DOCX |PDF

Condo and HOA Supplement – DOCX | PDF

Consultants- GL Supplement –DOCX | PDF

Contractors Equip Rental Supplement – DOCX | PDF

Dam Existence Hazard Supplement – DOCX | PDF

Day Nusery-Preschool Supplement – DOCX | PDF

Demolition Contractors- Annual Supplement – DOCX | PDF

Demolition Contractors- Per Job Basis Supplement – DOCX | PDF

Detective-Investigative Agencies Supplement – DOCX | PDF

Distributors and Wholesalers Supplement – DOCX | PDF

Drone Supplement – DOCX | PDF

Employment Agencies- Temp-Clerical Supplement – DOCX | PDF

Event -Party Planners Supplement – DOCX | PDF

Excavators and Graders Supplement – DOCX | PDF

Exercise and Health Studio Supplement – DOCX | PDF

Exterminators Supplement – DOCX | PDF

Fire Sprinkler Contractor Supplement – DOCX | PDF

Flea Market Supplement – DOCX | PDF

Foreclosure-Eviction Cleanup Contractors Supplement – DOCX | PDF

General Contractors-Developers Supplement – DOCX | PDF

Habitational Liability Supplement – DOCX | PDF

Habitational Property Supplement – DOCX | PDF

Halfway House Supplement – DOCX | PDF

Home Health Care Supplement – DOCX | PDF

Hunting Clubs Supplement – DOCX | PDF

Janitorial Supplement – DOCX | PDF

Landowners Supplement – DOCX | PDF

Landscaping Supplement – DOCX | PDF

Lessors Risk – DOCX | PDF

Liquor Liability Supplement – DOCX | PDF

Liquor Liability Special Event Supplement – DOCX | PDF

Machine Shop Supplement – DOCX | PDF

Machinery & Equipment Supplement – DOCX | PDF

Marijuana Related Supplement – DOCX | PDF

Martial Arts Supplement – DOCX | PDF

Medical Equip Supply Store Supplement – DOCX | PDF

Mobile Home Parks and Campgrounds Supplement – DOCX | PDF

Motel Supplement – DOCX | PDF

Outfitters and Guides Supplement – DOCX | PDF

Owners Contractors Protective Supplement – DOCX | PDF

Plastic Mfg Supplement – DOCX | PDF

Prize Indemnification Supplement – DOCX | PDF

Products Supplement – DOCX | PDF

Racing Special Events Supplement – DOCX | PDF

Real Estate Property Mgmt Supplement – DOCX | PDF

Recycler Supplement – DOCX | PDF

Roofers Supplement – DOCX | PDF

Schools Supplement – DOCX | PDF

Security and Patrol Supplement – DOCX | PDF

Snow Removal Supplement – DOCX | PDF

Special Events Supplement – DOCX | PDF

Sports Camps-Clinics-Leagues Supplement – DOCX | PDF

Swim and Racquet Clubs Supplement – DOCX | PDF

Swim Pool Contractors-Dealers-Installers Supplement – DOCX | PDF

Swim Pool Maintenance and Mgmt Supplement – DOCX | PDF

Tanning Salon Supplement – DOCX | PDF

Telecommunication Contractors Supplement – DOCX | PDF

Transportation Services Supplement – DOCX | PDF

Tree Trimmers Supplement – DOCX | PDF

Truckers GL Supplement – DOCX | PDF

Vacant Building Supplement – DOCX | PDF

Warehouse Supplement – DOCX | PDF

Water Supply Companies and Irrigation Systems Supplement – DOCX | PDF

Welding-Brazing-Cutting-09-16 Supplement – DOCX | PDF

Wind and Solar Energy Supplement – DOCX | PDF

Wood Manufacturing- Property Supplement – DOCX | PDF

Inland Marine Applications
Applications and forms are provided for your convenience. Using our applications and forms greatly enhance our ability to serve you and your clients. Our applications and forms can be viewed using either Microsoft Word or Adobe Acrobat Reader.

Contractors Equipment Application – DOC | PDF

Loggers Broad Form Property Damage Application – PDF

Liquor Liability
Applications and forms are provided for your convenience. Using our applications and forms greatly enhance our ability to serve you and your clients. Our applications and forms can be viewed using either Microsoft Word or Adobe Acrobat Reader.

Liquor Liability Application – DOCX | PDF

Liquor Liability For Special Events Application – DOCX | PDF

Misc Docs

Applications and forms are provided for your convenience. Using our applications and forms greatly enhance our ability to serve you and your clients. Our applications and forms can be viewed using either Microsoft Word or Adobe Acrobat Reader.

Diligent Effort – PDF

Markel Terrorism Form – PDF

Scottsdale (SIC) Terrorism Form – PDF

Personal Lines Applications

Applications and forms are provided for your convenience. Using our applications and forms greatly enhance our ability to serve you and your clients. Our applications and forms can be viewed using either Microsoft Word or Adobe Acrobat Reader.

Dwelling Fire – DOCX | PDF

Dwelling Liability – DOCX | PDF

Farm & Ranch – DOCX |PDF

Farm & Ranch – Cov E Supplemental – DOCX | PDF

Farm & Ranch – Cov G Supplemental – DOCX | PDF

Homeowners – DOCX | PDF

In Home Business Supplemental – DOCX | PDF

Personal Inland Marine – DOCX | PDF

Protection Class Supplemental – DOCX | PDF

Personal Umbrella – DOCX | PDF

Residential Builders Risk – DOCX | PDF

Trust, LLC, Partnership and Estate Supplemental – DOCX | PDF

Woodstove Supplemental – DOCX | PDF

Professional - DataBreach (Cyber)

Recovering from a breach is expensive and time consuming. Determining the cause and extent of the breach, complying with notice laws, correcting damage, minimizing losses, and addressing potential lawsuits can drain a business. That’s why MVGA has partnered with Markel to provide their one of a kind policy. Markel is a leader in this coverage area and we have specialists to help get your clients covered correctly.

App – DataBreach – MADB 5001 02 19

Supp – BI Reimbursement – MADB 5003 07 13

Supp – Contingent BI and System Failure – MADB 5006 11 18

Supp – Increased Limits – MAIL 1016 03 19

Supp – Representation of Claims – MAIL 6000 05 06

Professional - Employment Practice Liability

Any company that has employees needs this coverage to protect the assets of the company. We have partnered with one of the strongest carriers in the nation with this line of coverage. We are one of only a few general agencies that have access to this program and we pride ourselves on pre-underwriting risks to ensure a proper fit for the carrier and insured.

App – Mgmt Liab – For Profit – MAML 001 (05-10)

Professional - Info Technology

IT professionals are providing service under a continually evolving standard of care. An appropriate risk management program must include an insurance solution built upon an understanding of current and coming exposures. We have carriers that are specialists in insuring IT related risks.

App – Info Tech E&O – MAEO 2009 03 19

Supp – Data Privacy & Security – ZZ-31009 09 08

Supp – Employee Benefits – ZZ-31002-01 10 02

Supp – Representation of Claims – MAIL 6000 05 06

Professional - Management Liability - For Profit
Professional - Management Liability - Not For Profit
Professional - Products Liability - Claims Made

MVGA covers products on a specified basis, so we can supplement traditional insurance policies or fill the gap for new product development. Our flexible coverage can be packaged to meet the needs of manufacturers, importers, repackagers, sellers, or distributors of a wide range of products. We have the ability to meet non-standard risks head-on and offer innovative terms to solve the policyholder’s insurance needs.

App – Specified Products – MAGL 2003 (05-11)

App – Specified Professions – MAEO 2000 (11-14)

Supp – Employee Benefits – MAGL 2021 (11-12)

Supp – Medical Marijuana – MAGL 003 (04-10)

Supp – Nutraceuticals – MAGL 2053 (05-16)

Supp – Products Recall – MAGL 2020 (11-13)

Supp – Representation of Claims – MAIL 012 (05-11)

Professional - Tenant Discrimination

MVGA’s tenant discrimination policy provides industry leading protection for property owners and managers against claims brought by tenants alleging discrimination.

App – Tenant Discrimination – MATD 1000 (08-17)

Supp – Representation of Claims – MAIL 6000 (05-06)

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