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Energy Applications

We are in the process of converting our PDF’s to be fillable.

Use these fillable PDF applications to communicate details about accounts.  Then, simply email to your underwriter at Western Surplus with the click of a button.

To have the option to email and save these fillable forms, you will need Adobe Reader version 8 or 9. Download version 9 for FREE at http://www.adobe.com/products/reader/


Admiral
Additional Insured Supplemental Questionnaire - FILLABLE
Commercial GL Quick Application - FILLABLE
Consultant Supplemental - FILLABLE
Contractors Supplemental-Oil & Gas - FILLABLE
Control of Well - FILLABLE
Drilling Contractor Supplemental - FILLABLE
Engineer & Acrhitect Supplemental
Equipment Rental Supplemental - FILLABLE
Excess/Umbrella Renewal Application - FILLABLE
Gathering System Supplemental
GL Gas Pipeline Supplemental
GL Renewal Application - FILLABLE
Machine Shop Supplemental
Miscellaneous Medical Professional Liability Application
Oil Lease Operator with Well Schedule (Includes NOWI) - FILLABLE
Oil or Gas Equipment Application
Oil or Gas Valve Supplemental - FILLABLE
Oilfield Work
Pipe Testing Supplemental
Product Liability Supplemental
Professional Liability
Saltwater Disposal or Injection Wells Operated for Profit
Specialty Products Shop Supplemental
Statement of No Loss
Terrorism - FILLABLE
Truckers Supplemental - FILLABLE
Welding Supplemental - FILLABLE
Well Service Supplemental

Great American
Builders Risk

Lloyd's
Contractors Equipment Proposal
Terrorism - LMA 9011

Other Applications
Sub Producer Agency Profile - FILLABLE