When this form may help
Use this form to explain operations, materials handled, job sites, storage, transportation, waste practices, prior incidents, and the requested pollution coverage. Identify the actual environmental exposure rather than a generic contractor class.
Authority boundary: This Hedge form is a submission-preparation resource. It is not a quote, binder, coverage commitment, market-access statement, or instruction to release a risk to a carrier.
Topics covered
- pollution exposure
- materials
- job sites
- storage
- waste practices
- incidents
Before you send it
Complete the form with current facts from the insured. Confirm the named insured, operations, locations, requested coverage, effective date, and loss information. Include the primary application, loss runs, schedules, and other documents that apply to the account. Hedge will identify any additional market-specific requirements after review.
Download the fillable PDF
This file is published by Hedge and can be completed in a PDF editor. Review every answer before attaching it to a submission.
Download Hedge Environmental and Pollution Supplemental