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• Submission Information Guide
  
  
• Application Peerless (NJ, NY, PA, RI, MA, ME, VT, NH, CT)
  
  
• Application Wausau (All other states except TX, LA, HI)
  
  
• Employee Census
  
  
• Dealers Physical Damage Application
   
• Employment Practices Liability Application (Optional)
   
• Brokerage Agreement including W9 form
  
  

Peerless Insurance and WAUSAU Insurance are the primary underwriters for the Program and offer financial stability, excellent claims service, and specialized loss control services. Peerless and WAUSAU are members of the Liberty Mutual Group.