CoverXSpecialty | Experience Matters

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Applications

Please see the links below where you can download applications for your corresponding coverage need. Fill out the form and
send it to us by e-mail, fax or mail.

CoverXSpecialty
26600 Telegraph Road
Southfield, MI 48033

Phone: (800) 762-6837
Fax: (248) 358-2459
coverxuw@coverx.com

APPLICATION LISTING

Guard/Armored Car/Patrol/Detective or Investigative

Alarm Operations

Safety Program

Umbrella/Supported

Contractors Supplemental

Manufacturers/Distributors/Importers (Specified Products)

Transportation*

Oil and Gas Contractors and Suppliers

Workers’ Compensation

Restaurant Chain Application Claims Supplemental Form

Restaurant Chain Application Form

Suppliers & Component Parts Application Supplemental Form

Suppliers & Component Parts Application Form

Consumer Goods & Products Application Claims Supplemental Form

Consumer Goods & Products Application Form

Consumable Products Application Claims Supplemental Form

Consumable Products Application Form

Fraternal Organizations*

Convenience/Take-Out Stores*

Bowling Centers*

* Please contact your representative for this form.

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