Syndicate

CHART Syndicate Survey

Thank you for taking the time to complete this important survey. It should only take about 8 minutes to complete. And for eight minutes of your time we will give you a forum to help shape our group!

Coverholders and Risk Takers Exchange (CHART) = "to give something for something else."

NOTE: All information will be treated as confidential. No specific details regarding your program will be released to anyone without your prior authorization.

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* 1. General Syndicate Information

Syndicate Name:

Address:

Address 2:

City/Town:

State:

ZIP:

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* 2. Number of U.S.-based Coverholders Syndicate does business with annually:

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* 3. In which product lines does the Syndicate specialize (check all that apply)?

Property 

General Liability 

Workers Compensation 

Umbrella 

Auto 

Management Liability 

Medical Malpractice

Inland Marine

Other (please specify):

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* 1. General Syndicate Information

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* 2. Number of U.S.-based Coverholders Syndicate does business with annually:

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* 3. In which product lines does the Syndicate specialize (check all that apply)?

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* 4. Please provide a brief overview of the Carrier’s underwriting philosophy as it relates to the delegation of authorities to U.S.-based agencies: