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Welcome to Merchants' Supplemental Questionnaires

Please choose a supplemental questionnaire below by selecting the name of the desired file. This will open the form in the
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SUPPLEMENTAL QUESTIONNAIRE FORMS
Name Form Number
  Additional Insured MU 7986
  Auto Repair Garage MU 8164
  Auto Repair - EPLI Application for Renewals (NY) MU 9111
  Auto Repair - EPLI Application for Renewals MU 9112
  Building Owners MU 8100
  Commercial Auto Suspension Affidavit MU 9287
  Clubs or Member Organizations MU 7601
  Cyber Liability Application - Optional Increased Limits greater than $100,000 MU 9151
  Cyber Liability Renewal Application (All states except NY) MU 9152
  Concrete / Masonry Contractor MU 7987
  Contractors E&O Supplemental Application MU 9094
  Contractors E&O Supplemental Application (NY) MU 9120
  Contractors E&O Supplemental Application (NH) MU 9147
  Electrical Contractor MU 7988
  Employee Benefits Liability (EBL) Application (NY) MU 9198
  EPLI Application for New Business MU 9062
  EPLI Application for New Business (NY) MU 9060
  EPLI Application for New Business (VT) MU 9063
  EPLI Application for Renewals MU 9061
  EPLI Application for Renewals (NY) MU 9070
  EPLI Application for Renewals (VT) MU 9067
  Excavation / Grading of Land Contractor MU 7989
  Glazier Supplemental Application MU 7994
  Janitorial Contractor MU 7990
  Landscape Gardening Contractor MU 7991
  Lead Exposure MU 7992
  Manufacturing E & O Coverage Part Application (MA) MU 9082
  Manufacturing E & O Coverage Part Application (MI) MU 9029
  Manufacturing E & O Coverage Part Application (NH) MU 9077
  Manufacturing E & O Coverage Part Application (NY) MU 9050
  Manufacturing E & O Coverage Part Application (OH & PA) MU 9042
  Manufacturing Supplemental Application - Non-metal Manufacturers MU 9030
  Manufacturing Supplemental Application - Food Manufacturers MU 9031
  Manufacturing Supplemental Application - Metal Works Manufacturing MU 9032
  Manufacturing Supplemental Application - Beverage Manufacturing MU 9033
  Michigan Liability Coverage Limits and PIP Med Expense Selection MU 9284
  Painting Contractor MU 7993
  Paving Contractor MU 8101
  Pesticide / Herbicide MU 8102
  Plumbing / HVAC Contractor MU 9206
  Real Estate Office MU 7995
  Restaurant Supplemental Acord 185
  Septic Contractor MU 9195
  Snowplowing Supplement - GL and Auto MU 7996
  Snowplowing Supplement - Monoline Auto MU 9312
  Spray Painting/Collision Shop Supplement MU 8313
  Umbrella UM Coverage Selection Form NH MU 9167
  Umbrella UM Coverage Selection Form VT MU 9166
  Vacant Land Questionnaire MU 7997
  VT General Liability -- Pollution Exclusion MU 7965


Last Updated: Friday, July 8, 2022
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