Amendment 2.docx

State of South Carolina

Invitation For Bid

Amendment 2 Solicitation:

Date Issued:

Procurement Officer:

Phone:

E-Mail Address:

Mailing Address:

5400026089 11/22/2023

KAYLA MIDDLETON

803-737-2609 kmiddleton@mmo.sc.gov SFAA, Div. of Procurement Services, MMO PO Box 101103 1201 Main St., Suite 600 Columbia SC 29211

DESCRIPTION: Multimedia Insurance Policy

USING GOVERNMENTAL UNIT: South Carolina Education Television Commission (SCETV)

SUBMIT YOUR OFFER ON-LINE AT THE FOLLOWING URL: http://www.procurement.sc.gov

SUBMIT OFFER BY (Opening Date/Time): 11/21/2023 11/29/2023 11:00:00 AM (See "Deadline For Submission Of Offer" provision)

QUESTIONS MUST BE RECEIVED BY: 11/6/2023 12:00:00 PM (See "Questions From Offerors" provision)

NUMBER OF COPIES TO BE SUBMITTED: One (1) Online Submission

CONFERENCE TYPE: N/A

DATE & TIME: (As appropriate, see "Conferences - Pre-Bid/Proposal" & "Site Visit" provisions)

LOCATION: N/A

You must submit a signed copy of this form with Your Offer. By signing, You agree to be bound by the terms of the Solicitation. You agree to hold Your Offer open for a minimum of thirty (30) calendar days after the Opening Date. (See "Signing Your Offer" provision.)

NAME OF OFFEROR

(full legal name of business submitting the offer) Any award issued will be issued to, and the contract will be formed with, the entity identified as the Offeror. The entity named as the offeror must be a single and distinct legal entity. Do not use the name of a branch office or a division of a larger entity if the branch or division is not a separate legal entity, i.e., a separate corporation, partnership, sole proprietorship, etc.

AUTHORIZED SIGNATURE

(Person must be authorized to submit binding offer to contract on behalf of Offeror.)

DATE SIGNED

TITLE

(business title of person signing above)

STATE VENDOR NO.

(Register to Obtain S.C. Vendor No. at www.procurement.sc.gov)

PRINTED NAME

(printed name of person signing above)

STATE OF INCORPORATION

(If you are a corporation, identify the state of incorporation.)

OFFEROR'S TYPE OF ENTITY: (Check one) (See "Signing Your Offer" provision.)

___ Sole Proprietorship ___ Partnership ___ Other_____________________________

___ Corporate entity (not tax-exempt) ___ Corporation (tax-exempt) ___ Government entity (federal, state, or local)

COVER PAGE - ON-LINE ONLY (MAR. 2015)

SAP

SAP

PAGE TWO

(Return Page Two with Your Offer) HOME OFFICE ADDRESS (Address for offeror's home office / principal place of business)

NOTICE ADDRESS (Address to which all procurement and contract related notices should be sent.) (See "Notice" clause)

_________________________________________________ Area Code - Number - Extension Facsimile

_________________________________________________ E-mail Address

PAYMENT ADDRESS (Address to which payments will be sent.) (See "Payment" clause)

____Payment Address same as Home Office Address ____Payment Address same as Notice Address (check only one) ORDER ADDRESS (Address to which purchase orders will be sent) (See "Purchase Orders and "Contract Documents" clauses)

____Order Address same as Home Office Address ____Order Address same as Notice Address (check only one)

ACKNOWLEDGMENT OF AMENDMENTS

Offerors acknowledges receipt of amendments by indicating amendment number and its date of issue. (See "Amendments to Solicitation" Provision)

DISCOUNT FOR PROMPT PAYMENT

(See "Discount for Prompt Payment" clause)

PREFERENCES - A NOTICE TO VENDORS (SEP. 2009): On June 16, 2009, the South Carolina General Assembly rewrote the law governing preferences available to in-state vendors, vendors using in-state subcontractors, and vendors selling in-state or US end products. This law appears in Section 11-35-1524 of the South Carolina Code of Laws. A summary of the new preferences is available at www.procurement.sc.gov/preferences . ALL THE PREFERENCES MUST BE CLAIMED AND ARE APPLIED BY LINE ITEM, REGARDLESS OF WHETHER AWARD IS MADE BY ITEM OR LOT. VENDORS ARE CAUTIONED TO CAREFULLY REVIEW THE STATUTE BEFORE CLAIMING ANY PREFERENCES. THE REQUIREMENTS TO QUALIFY HAVE CHANGED. IF YOU REQUEST A PREFERENCE, YOU ARE CERTIFYING THAT YOUR OFFER QUALIFIES FOR THE PREFERENCE YOU'VE CLAIMED. IMPROPERLY REQUESTING A PREFERENCE CAN HAVE SERIOUS CONSEQUENCES. [11-35-1524(E)(4)&(6)]

PREFERENCES - ADDRESS AND PHONE OF IN-STATE OFFICE: Please provide the address and phone number for your in-state office in the space provided below. An in-state office is necessary to claim either the Resident Vendor Preference (11-35-1524(C)(1)(i)&(ii)) or the Resident Contractor Preference (11-35-1524(C)(1)(iii)). Accordingly, you must provide this information to qualify for the preference. An in-state office is not required, but can be beneficial, if you are claiming the Resident Subcontractor Preference (11-35-1524(D)).

____In-State Office Address same as Home Office Address ____In-State Office Address same as Notice Address (check only one)

PAGE TWO (SEP 2009)

End of PAGE TWO

QUESTIONS FROM OFFERORS - AMENDMENT (JUN 2017)

THE SOLICITATION IS AMENDED AS PROVIDED HEREIN. INFORMATION OR CHANGES RESULTING FROM QUESTIONS WILL BE SHOWN IN A QUESTION-AND-ANSWER FORMAT. ALL QUESTIONS RECEIVED HAVE BEEN REPRINTED BELOW. THE “STATE’S RESPONSE” SHOULD BE READ WITHOUT REFERENCE TO THE QUESTIONS. THE QUESTIONS ARE INCLUDED SOLELY TO PROVIDE A CROSS-REFERENCE TO THE POTENTIAL OFFEROR THAT SUBMITTED THE QUESTION. QUESTIONS DO NOT FORM A PART OF THE CONTRACT; THE “STATE’S RESPONSE” DOES. ANY RESTATEMENT OF PART OR ALL OF AN EXISTING PROVISION OF THE SOLICITATION IN AN ANSWER DOES NOT MODIFY THE ORIGINAL PROVISION EXCEPT AS FOLLOWS: UNDERLINED TEXT IS ADDED TO THE ORIGINAL PROVISON. STRICKEN TEXT IS DELETED. [02-2A097-1]

The following questions were received pursuant to the original date and time specified on the front of the solicitation:

1. The underwriters wanted me to ask what are the last five jobs that have been completed and if you would provide the current carrier’s name.

Agency Response: The last five jobs that have been completed are Making It Grow (TV), This Week in South Carolina (TV), From The Sky (TV & Web), After Action (TV), In Debted (FM & Podcast), SC Lede (FM & Podcast), and By The River (TV). There is currently no carrier’s name.

2.

Agency Response: The agency chooses not to answer the business application until an award is made with a responsive/responsible offeror.

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EPACK3 NEW BUSINESS APPLICATION MEDIA MPL Cyber[32].docx [Type here]

1. Date the Applicant was established:

2. Ownership Structure: Private ☐ Public ☐ Not-for-Profit ☐ Governmental ☐

3. Business Type: Corporation ☐ Partnership ☐ Joint Venture ☐ LLC ☐

4. Number of Employees:

5. Is the Applicant wholly or partially owned or controlled by any other entity? Yes ☐ No ☐ If you answered “Yes” above, please provide the name, date established, location and degree of control for each such entity:

6. Does the Applicant, either in whole or part, own, control, manage or operate any other entity not previously listed in this Application? Yes ☐ No ☐

If you answered “Yes” above, please provide complete details:

7.Area or territory of operations: Local ☐ Regional ☐ National ☐ International ☐

What is the nature of the Applicant’s business?

8. COVERAGE REQUESTS

Coverage

Limit

Retention

Retroactive Date

Cyber

Media Liability

Technology and Professional Liability

9. EXPIRING COVERAGE INFORMATION (Applicable To All Coverages)

Please complete the following for those coverages for which you are currently insured:

Coverage

Limit

Retention

Retroactive Date

Premium

Carrier

Expiration Date

Cyber

Media Liability

Technology and Professional Liability

10. Has the insurer under any of the coverages listed above indicated an intent not to offer renewal terms? (THIS

QUESTION IS NOT APPLICABLE TO MISSOURI RESIDENTS) Yes ☐ No ☐

11. GENERAL INFORMATION

In the next 12 months (or during the past 18 months), indicate whether the Applicant or any Subsidiary has experienced, or anticipates any of the following:

a. Merger, consolidation, acquisition, or divesture? Yes ☐ No ☐

b. Material changes in nature or size of operations? Yes ☐ No ☐

c. Bankruptcy filing or re-organization? Yes ☐ No ☐

If you answered “Yes” to any of the above, please provide complete details (if additional space is needed, please attach separately):

12. FINANCIAL INFORMATION

Please indicate the Applicant’s Gross Annual Revenue

Prior Year

Current Year

Projected

. Please indicate the percentage of the Applicant’s revenue generated inside the United States versus the percentage generated outside of the United States:

US: % Foreign: %

13. CLAIMS INFORMATION

Has notice of any claim, potential claim, first party loss (including but not limited to data breach, security breach, extortion demand, or release/loss/disclosure of or unauthorized access to personally identifiable information in the

Applicant’s care, custody, or control), or potential first party loss, been given to any insurer for any coverage for which the Applicant is applying? Yes ☐ No ☐

Within the past 3 years, has the Applicant, any Subsidiary, or any person associated with such entities for whom this insurance is being sought (“Proposed Insureds”), been the subject of, or involved in, any claim, written demand, notice, proceeding, litigation, or investigation alleging:

a. Violations of any federal or state privacy or data security laws or regulations? Yes ☐ No ☐

b. Privacy injury, identity theft, denial of service attacks, computer virus infections, theft of information, damage to third party networks, or the inability of the Applicant’s or Subsidiary’s authorized users to access the Applicant’s or Subsidiary’s network? Yes ☐ No ☐

c. A loss of money, securities, or property due to social engineering, fraud, or other criminal acts?

Yes ☐ No ☐

d. An act, error, omission, neglect, breach of duty, or personal or proprietary injury while rendering or failing to render professional services or technology services? Yes ☐ No ☐

e. An act, error, omission, neglect, breach of duty, or personal or proprietary injury which results in the failure of a product to perform its intended purpose? Yes ☐ No ☐

f. Defamation, disparagement, invasion or interferences with rights of privacy or publicity, wrongful entry or eviction, false arrest, infringement of intellectual property, infliction of emotional distress, or unfair competition or unfair trespass, in the gathering or dissemination of any content? Yes ☐ No ☐

14.Within the past 3 years, has any Proposed Insured been the subject of any inquiries, investigations, or disciplinary action by a regulatory or administrative agency or association? Yes ☐ No ☐

15.Within the past 3 years, has any Proposed Insured been made aware of any potential first party loss (including but not limited to data breach, security breach, extortion demand, or release/loss/disclosure of or unauthorized access to personally identifiable information in the Applicant’s care, custody, or control), whether or not reported t a prior insurer? Yes ☐ No ☐

If you answered “Yes” to any of the questions in paragraphs 1. through 4. above, please provide details, including date, type of claim or first party loss, allegations, current status, defense costs incurred, and any judgment or settlement amounts. (If additional space is needed, please attach separately):

. 16. CYBER COVERAGE PART

(to be completed only if the Applicant is seeking Cyber coverage)

A. Sensitive Information

1. Please identify any sensitive employee, customer, or client information that the Applicant has possession of:

Type of Information

Estimated Number of Records

Are These Records Encrypted at Rest

Are These Records Encrypted in Transit

Social Security Numbers

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Driver’s License Numbers

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Financial Account Numbers

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Credit Card Numbers

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Personal Health Information

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Biometric Data

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Third Party Trade Secrets

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Third Party Intellectual Property

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Third Party Corporate Financial Information

Yes ☐ No ☐

Yes ☐ No ☐ Not applicable ☐

Total

2. Is there any segregation of the data discussed in question 1 above? Yes ☐ No ☐

If you answered “Yes” above, what is the largest number of records stored in one place?

3. Is any of the information discussed in question 1 above stored on mobile devices (i.e. laptops, tablets, mobile phones, etc.)? Yes ☐ No ☐

If you answered “Yes” above, is it encrypted at rest and in transit? Yes ☐ No ☐

4. Is any of the above information discussed in question 1 above from non-US residents or non-US domiciled companies? Yes ☐ No ☐ N/A ☐

B. Information Security and Privacy Policies

1. Please indicate if the Applicant:

Yes

No

a. Has a specific individual responsible for overall privacy and information security?

b. Has a specific individual responsible for monitoring changes in statutes and regulations related to privacy and information security?

c. Has formal written information security and privacy policies, standards, and/or procedures for the administration of information security throughout your organization?

d. Has a written records retention policy that includes the secure disposal/deletion of paper/electronic records, biometric information, and data when no longer needed?

e. Stores data only as necessary for the performance of services?

f. Has had the information security and privacy policies been reviewed by an outside counsel specializing in privacy law?

g. Has a formal security awareness and education program to support and communicate new and existing standards and policies to employees?

h. Requires that every person in the organization be given anti-fraud security awareness training on an ongoing basis that includes but is not limited to detection of social engineering, phishing or other similar scams?

i. Has a formal and comprehensive employee on-boarding process (including background checks, drug tests, criminal, credit, etc.)?

2. Is the Applicant in compliance with:

Yes

No

NA

a. EU General Data Protection Regulation?

b. Health Insurance Portability and Accountability Act?

c. Graham Leach Bliley Act?

d. California Consumer Privacy Act?

e. Any state or Federal Biometric Information Protection statute or regulation?

C. Network Security Controls

1. Does the Applicant:

Yes

No

a. Utilize any unsupported operating systems? (e.g. Windows XP, or Server 2003)

b. Assess applications and infrastructure for common security vulnerabilities (e.g. OWASP top 10, SANS 20)?

c. Replace factory default settings (including user names and passwords) to ensure your information security systems are securely configured?

d. Implement segregation of duties for development, testing, and production environments?

e. Check for security patches to your systems at least weekly and implement them within 30 days?

If you answered “No”, please provide an overview of your patching process:

2. How often does the Applicant have third parties conduct regular network and application penetration tests?

3. Have all medium/high/critical findings in the most recent test been remediated? Yes ☐ No ☐

4. How often does the Applicant perform formal risk assessments?

5. Does the Applicant perform regular backups of data, applications, and system configurations?

Yes ☐ No ☐

If you answered “Yes” above, are the backups:

a. Regularly tested to ensure restorability? Yes ☐ No ☐

b. Stored offsite and offline? Yes ☐ No ☐

c. Encrypted at rest? Yes ☐ No ☐

6. Does the Applicant have the following in place:

Yes

No

a. Up to date Anti-Virus Software

b. Multi Factor Authentication for remote connection to the Applicant’s network?

c. Multi Factor Authentication for privileged user access?

d. Virtual Private Network (VPN), SSL VPN or equivalent technology?

e. A Security Information and Event Management (SIEM) system?

f. Data Leakage Prevention technology or other similar programs/technologies?

g. Wi-Fi- Protected Access 2 Authentication and Encryption or stronger on the Applicant’s wireless network?

h. Password practices and controls (i.e. minimum password length, characters and/or capitalized letters?

7. Does the Applicant:

Yes

No

a. Control access to your system to ensure that users only have access to the appropriate environments necessary for their work?

b. Audit user access to ensure no authorization has been granted that exceeds employees’ job responsibilities?

If you answered “Yes”, how often?

c. Timely remove systems access when an individual leaves the organization and/or when access is no longer required for business purposes?

What is the time frame?

d. Limit physical access at all locations to your own personnel and only authorized sub-contractors, agents, or visitors?

8. Does the Applicant enforce the following for access control to data centers and networking closets:

Yes

No

a. Badge access

b. Biometrics

c. Automatic locking

d. Time alarms for open doors

D. Incident Response/Business Continuity/Disaster Recovery Plans

1. Does the Applicant have any of the following formal plans in place:

a. Incident Response Plan in place? Yes ☐ No ☐

b. Business Continuity Plan in place? Yes ☐ No ☐

c. Disaster Recovery Plan in place? Yes ☐ No ☐

If you answered “Yes” to any of the above, how often are these plans tested?

2. If the Applicant suffered a network disruption, how long would it take to become fully operational?

1-4 hours ☐ 4-8 hours ☐ 8-12 hours ☐ 12-24 hours ☐ 24-48 hours ☐ 48+ hours ☐

E. Third Party Vendors and Service Providers

1. Whenever the Applicant entrusts sensitive information to 3rd parties does the Applicant:

Yes

No

a. Contractually require all such third parties to protect this information with safeguards at least equivalent to the Applicant’s safeguards?

b. Perform due diligence on each such third party to ensure that their safeguards for protecting sensitive information meet the Applicant’s standards (e.g. conduct security/privacy audits or review findings of independent security/privacy auditors)?

c. Audit all such third parties at least once a year to ensure that they continuously satisfy the Applicant’s standards for safeguarding sensitive information?

d. Contractually require in writing that they defend and indemnify the Applicant if they contribute to a confidentiality, security, and/or privacy breach?

e. Require all such third parties to either have sufficient liquid assets or maintain enough Errors & Omissions insurance to cover their liability arising from a breach of privacy or confidentiality?

f. Request SOC 2 reports

2. Current Network and Technology Providers (If applicable)

Internet Service Provider (s)

Cloud Services Provider (s)

Website Hosting

Collocation Services

Credit Card Processor(s)

Managed Security Services

Other(s)

3. What percentage of the Applicant’s revenue is directly dependent on public facing websites? %

4. What is the minimum length of system outage for which the Applicant would anticipate a measurable impact on revenue?

F. Personal Health Information

1. Does the Applicant process, transmit, store, or use Personal Health Information (PHI) or is the

Applicant a “Covered Entity” or: “Business Associate” per the Health Insurance Portability and

Accountability Act? Yes ☐ No ☐

2. If you answered “Yes” to the above

Yes

No

a. Is a risk analysis performed to determine where PHI is being used and stored to identify the gaps and possible threats to said PHI?

b. Is access to PHI data/information restricted to only those that need access?

c. Is there a PHI specific incident response plan in place?

d. Are users trained on PHI security?

e. Are the information security and privacy controls discussed above in place and applicable to PHI in the Applicant’s possession or control?

G. Payment Card Information

1. Does the Applicant accept payment via credit/debit card? Yes ☐ No ☐

If you answered “No” above, please skip to Section H, Cyber Crime

2. Has the Applicant confirmed the Applicant’s compliance with the PCI DSS (Payment Card Industry Data

Security Standard)? Yes ☐ No ☐

a. If so, which version of the PCI Standard is the Applicant compliant with?

b. How many transactions does the Applicant conduct on an annual basis?

c. On what percentage of the Applicant’s transactions is Europay, MasterCard, Visa (EMV Chip and Pin) or such similar tokenization used? %

3. If you answered “Yes” to the above:

Yes

No

a. Is segmentation used to isolate PCI information from the rest of the corporate network?

b. Is Tokenization used to remove the actual credit card number from the transaction?

c. Is there a policy and procedure for deploying patches to the point of sale devices?

d. Are connectivity restrictions in place to disallow internet?

access from point of sale devices?

e. Are the point of sale devices hardened via application whitelisting?

f. Is end to end encryption utilized from the moment credit card information is read into the point of sale device?

4. Please indicate if the following information is in custody, care or control:

Yes

No

a. Credit card data for the duration of a transaction

b. Credit card data stored for future use (all but last 4 digits masked)

c. Credit card data stored for future use (un-masked card numbers including track 2 data)

H. Cyber Crime

(to be completed only if the Applicant is seeking Cyber Crime coverage)

1. Does the Applicant:

Yes

No

a. Have procedures in place to verify the receipt of inventory, supplies, goods or services against an invoice prior to paying a vendor?

b. Have a written policy regarding electronic fund transfers?

c. Accept funds transfer instructions or changes to account details from internal sources

(employees, etc.) or external sources (customers, vendors, etc.) over the telephone, fax, email or some other electronic communications method?

If you answered “Yes”, prior to complying with the instruction, does the Applicant authenticate such instructions using a method other than the initial contact method? Yes ☐ No ☐

d. Limit authority to execute electronic transfers to specified employees?

e. Restrict access to the online banking portal used to conduct electronic transfer functions to specific users and terminals?

f. Require dual authorizations for payments or funds transfers of a certain amount?

If you answered “Yes”, what is that amount? $

g. Have different policies and procedures for international electronic fund transfers? If yes, please explain in an attachment to this application

.3. What is the average monthly number of fund transfers?

4. What is the average dollar amount of an individual fund transfer? $

.5. What is the largest single amount that can be transferred? $

VIII. MEDIA LIABILITY COVERAGE PART

(to be completed only if the Applicant is seeking Media Liability coverage)

A. Coverage Type

1. Coverage type: Claims Made ☐ Occurrence ☐

2. Sublimited Optional additional coverages

(to be completed only if the Applicant is seeking such coverage):

a. Subpoena assistance coverage: $

b. First Amendment event coverage: $

B. Marketing and Advertising Budget

Please indicate the advertising/marketing budget for the following 12 month fiscal periods.

Prior Fiscal Year

Current Fiscal Year

Next Fiscal Year (projected)

US

International

US

International

US

International

C. Media Controls Risk Management

(if the applicant is an advertising or public relations agency or is engaged in the distribution of media, please complete the Advertising Agency or Distributor Supplement)

1. Does the Applicant have an in-house legal department experienced in media law issues?

Yes ☐ No ☐

2. How many trade or service marks does the applicant currently own?

3. For the proposed policy period, does the Applicant plan to use any of the Applicant’s existing trade or service marks in connection with any new class(es) of goods or services for which the marks have not previously been used? Yes ☐ No ☐

If you answered “Yes” above, please describe: .

4. Does the Applicant engage outside counsel specializing in trademark law in connection with

The development or use of the Applicant’s marks and products? Yes ☐ No ☐

If you answered “Yes” above, please provide the name of the firm name and/or counsel used:

If you answered “No” above, please explain: .

5. Does the Applicant always perform trademark clearance searches in connection with new marks or when expanding into new classes of goods or services? Yes ☐ No ☐

6. Does the Applicant create advertising and/or marketing materials internally or does the Applicant employ an outside advertising agency? Internally ☐ Outside agency ☐

If you indicated “Outside Agency” above, has the agency agreed to indemnify the Applicant for claims arising from the content created by the agency? Yes ☐ No ☐

7. Does the Applicant engage in comparative advertising? Yes ☐ No ☐

8. Does the Applicant utilize a website or social media to advertise or promote its products or services?

Yes ☐ No ☐

If you answered “Yes” above:,

a. Are the websites or social media controlled and operated by employees of the Applicant who are dedicated to such platforms? Yes ☐ No ☐

b. Please indicate the websites and/or social media accounts so used:

9. Does the Applicant have a written employee social media policy? Yes ☐ No ☐

10. Does the Applicant have a process for legal review of all advertising, marketing, and promotional content, including website and social media content, prior to dissemination? Yes ☐ No ☐

11. Does the Applicant have procedures to ensure new employees are not using or taking trade secrets or other confidential property or information from prior employers? Yes ☐ No ☐

12. If the Applicant is engaged in software development or distribution, is an outside counsel specializing in the relevant areas of law involved and/or consulted during the development process? Yes ☐ No ☐

13. Does the Applicant utilize written contracts in connection with its media activities such as advertising, marketing, etc.? Yes ☐ No ☐

If you answered “No” above, please explain:

If you answered “Yes” above:

a. Please indicate the percentage of standard Applicant contracts vs. client/vendor contracts used:

i. Applicant’s standard contract: %

ii. Client/vendor’s contract: %

b. Does each contract contain a/an (select all that apply):

i. ☐ Disclaimer of Warranties

ii. ☐ Alternative Dispute Resolution Clause

iii. ☐ Exclusions of consequential damages

iv. ☐ Hold harmless/indemnity in favor of the Applicant

v. ☐ Limitation of liability

vi. ☐ Choice of venue/governing law

vii. ☐ Statement of work/specifications viii.☐ Force majeure

ix. ☐ Performance milestones/schedule of performance deadlines

14. Please indicate which of the following quality control/risk management procedures the Applicant uses in connection with the Applicant’s media activities (select all that apply):

a. ☐ Legal review and clearance of advertising and/or content by in-house counsel

b. ☐ Website/social media content conduct and policy

c. ☐ Fact checking for published content

d. ☐ Delay device used for live transmissions/broadcasts

e. ☐ Use of work-for-hire agreements for advertising and/or content created by third parties including freelancers

f. ☐ Legal review and clearance of advertising and/or content by outside counsel specializing in the relevant areas of law

g. ☐ Client approval prior to dissemination of content

h. ☐ Correction/retraction procedures

i. ☐ Confirmation that licensing agreements are in place for third party content used including photos, video/film, or music, etc.

j. ☐ Training of employees regarding libel and related claims

k. ☐ Training of employees regarding copyright, trademark, and other content claims

l. ☐ Risk manager on staff

m. ☐ Confirmation that releases are obtained from all persons depicted in advertising and/or content

VIII. TECHNOLOGY AND PROFESSIONAL LIABILITY COVERAGE PART

(to be completed only if the Applicant is seeking Technology and Professional Liability coverage)

A. Revenue Percentages

1. Please estimate the total percentage of revenue from the following technology and telecommunication activities:

Tech - Software & Services

Percentage

Tech - Hardware & Equipment

Percentage

Application Service Provider

Technology Equipment Manufacturing

Custom Software Development

Computer Hardware Manufacturing

Data Processing & Outsourced Services

Computer Storage & Peripherals

Domain Name Registration

Electronic Equipment Manufacturing

Information Management

Electronic Manufacturing Services

Internet Service Provider

Office Electronics Manufacturer

IT Consulting

Semiconductors

Network Security Software and Services

Technology Distributors

Pre-Packaged Software Development/Sales

Other (describe)

System Design and Integration

Technical Support/Repair & Maintenance

Telecommunication

Percentage

Web Portal

Alternative Carrier Provider

Website Construction and Design

Integrated Telecommunication Services

Other (describe)

Wireless Telecommunications Services

2. Please estimate the total percentage of revenue from the following miscellaneous professional services:

Miscellaneous Professional Service

Percentage

Miscellaneous Professional Service

Percentage

Alternative Dispute Resolution

Equipment Lease Brokerage

Answering Services

Executive Coaching

Association Professional Liability

Executive Search Firms

Association Management

Expert Witnesses

Billing Services

Franchising

Bookkeeping Services

Freight Forwarders

Business Brokers

Fulfillment Services

Business Process Outsourcing

Hotel Management

Call Center Services

Human Resource Consulting

Claims Adjusters

Litigation Support

Consulting Services

Marketing Consulting / Research

Courier Services

Meeting / Event Planning

Court Reporting Services

Notary

Credit Reporting Agency Services

Payroll Processing

Custom House Brokerage

Permanent Placement

Direct Mail Services

Physician Practice Management

Document Destruction Services

Premium Financing

Document Storage Services

Translation / Transcription

Drug Testing

Travel Agent

Educational Testing

Trustee Services

Employment Screening

Other (describe)

B. Client / Customer Information

1. Provide the following information regarding the Applicant’s 5 largest clients (determined as a percentage of the total gross revenue for the past fiscal year):

Client

Size of Contract

Length of Contract

Description of Services

2. What is the percentage of sales to repeat customers? %

3. Please state the technical level of sophistication of the Applicant’s average customer:

a. ☐ Novice

b. ☐ Average

c. ☐ Sophisticated

4. Are procedures in place to evaluate the financial condition and legitimacy of all new clients? Yes ☐ No ☐

5. Please indicate the percentage of products and services the Applicant provides to the following customer segments:

Customer Segment

Percentage of Services/Products

Commercial Client

Individual Consumers

United States Federal Government

United States State And Local Governments

Foreign Governments

6. Please indicate the percentage of revenue derived from the following business sectors:

Business Sector

Percentage of Receipts

Business Sector

Percentage of Receipts

Aerospace & Defense

Financial Services

Automobiles & Components

Healthcare

Chemical

Information Technology

Construction & Engineering

Media

Consumer Services

Oil, Gas & Utilities

Electrical Equipment

Retail

Energy Equipment & Services

Telecommunication

C. Contractual Procedures

1. Does the Applicant require the use of a written contract or agreement for all engagements?

Yes ☐ No ☐

If you answered “No” above, what percentage of contracts are in writing? %

2. Does the Applicant maintain and enforce a contractual review process? Yes ☐ No ☐

If you answered “Yes” above, does this process include review by outside counsel specializing in contract law? Yes ☐ No ☐

3. Does the Applicant have a standard written contract that the Applicant proposes to use on most engagements? Yes ☐ No ☐

4. Please indicate the percentage of contracts where the Applicant’s standard contract, the customer’s contract, or a combination of both is used:

a. Standard: %

b. Customer: %

c. Combination: %

5. Please indicate the contractual provisions the Applicant use in most contracts (select all that apply):

a. ☐ Disclaimer of warranties

b. ☐ Dispute resolution

c. ☐ Exclusions for consequential damages

d. ☐ Exclusive remedies

e. ☐ Force majeure

f. ☐ Hold harmless in favor of the Applicant

g. ☐ Limitation of liability

h. ☐ Performance milestone

i. ☐ Statement of work

j. ☐ Venue/governing law

6. Does the Applicant have a formal customer acceptance process in place? Yes ☐ No ☐

7. Are performance milestones accepted with signoffs by both parties?

Yes ☐ No ☐

8. Are interim changes in contracts documented and signed off by both parties? Yes ☐ No ☐

D. Historical Business Information

1. Does the Applicant have any account receivables for professional or technology service contracts that are more than 90 days past due? Yes ☐ No ☐

2. Within the past 5 years, has the Applicant sued any customers for non-payment of any contract or licensing fees? Yes ☐ No ☐

3. Within the past 5 years, have any clients withheld payment or requested a refund of fees because the Applicant’s products/services:

a. Did not meet the client’s performance expectations? Yes ☐ No ☐

b. Did not perform in compliance with the Applicant’s warranty or guarantees? Yes ☐ No ☐

E. Quality Control Procedures

1. Does the Applicant employ a risk manager? Yes ☐ No ☐

If you answered “No” above, please indicate who is responsible for handling insurance related matters: .

2. Does the Applicant have policies and procedures in place to respond to customer complaints? Yes ☐ No ☐

3. Does the Applicant utilize an escalation procedure to respond to customer complaints? Yes ☐ No ☐

4. Please indicate which of the quality control procedures are in place (select all that apply):

a. ☐ Alpha testing

b. ☐ Customer service via e-mail

c. ☐ Beta testing

d. ☐ Formalized training for new hires

e. ☐ Business continuity plan

f. ☐ Prototype development

g. ☐ Customer Screening Process

h. ☐ Vendor certification process

i. ☐ Customer service via a toll-free number

j. ☐ Written quality control guidelines

k. ☐ Customer service via a web portal

F. Subcontracted Work

1. Does the Applicant sub-contract any professional services or manufacturing to fulfill commitments to clients? Yes ☐ No ☐

If you answered “Yes” above, what percentage does the Applicant sub-contract? %

2. Does the Applicant utilize a standard sub-contractor contract? Yes ☐ No ☐

3. Does the Applicant require evidence of General Liability or Errors and Omissions insurance from subcontractors? Yes ☐ No ☐

APPLICANT REPRESENTATION

(To Be Completed by Applicant)

The Applicant Representation applies to all coverages that have been completed as part of this Application.

1. Special Representation applicable to the following Coverages only (if to be part of this policy):

For the coverages checked below, the Applicant has current coverages in place with either CNA or with any other carrier:

Coverages:

Coverage has been in place since:

☐ Cyber

☐ Media Liability

☐ Technology and Professional

Liability

The Applicant requests continuity for these coverages and this Applicant Representation does not apply to these coverages.

If no checkboxes are checked above then this Applicant Representation applies to any of these coverages for which the Application has been completed subject to the following:

Applicant Representation - None of the individuals to be insured under any Coverage Part is responsible for or has knowledge of any wrongful act or fact, circumstance, or situation which they have reason to believe might result in a future claim or first party loss, except as follows:

☐ Yes, there are exceptions to this Representation (please attach details)

☐ No, there are no exceptions to this Representation

If any wrongful act or fact, circumstance, or situation which the Applicant has reason to believe might result in a future claim or first party loss whether not disclosed above, then the Applicant acknowledges and agrees, unless the proposed insurance policy expressly provides otherwise, any loss, claim, action, or first party loss arising out of, based upon, or attributable to such wrongful act or fact, circumstance, or situation will be excluded from coverage in accordance with the Application provision of the proposed policy.

2. Representations applicable to all coverages to be made part of this policy:

The Applicant hereby declares, after diligent inquiry, that the information contained herein and in any supplemental applications or forms required hereby are true, accurate, and complete, and that no material facts have been suppressed or misstated. The Applicant acknowledges a continuing obligation to report to the CNA Company (the “Company”) to whom this Application is made, as soon as practicable, any material changes in all such information after signing the Application and prior to issuance of the policy. The Applicant further acknowledges that the Company will have the right to withdraw or modify any outstanding quotations and/or authorizations or agreement to bind the insurance based upon such changes. (For Maine residents only: The Company cannot withdraw any authorization or agreement to bind the insurance.)

Further, the Applicant understands and acknowledges that:

a. Completion of this Application and any supplemental applications or forms does not bind the Company to issue a policy;

b. If a policy is issued, the Company has relied upon, as representations, this Application, any supplemental application, and other statements furnished to the Company in conjunction with this Application;

c. All supplemental applications, statements, and other materials furnished to the Company in conjunction with this Application are hereby incorporated by reference into this Application and made a part hereof;

d. This Application will be the basis of the contract and will be incorporated by references into and made a part of such policy;

e. If a policy is issued, the limit of liability contained in the policy will be reduced and may be completely exhausted by the payment of loss, defense costs, and expenses. In such event the Company will not be liable for loss, defense costs, and expenses to the extent that such loss, expenses, and defense costs exceed the limit of liability of this policy;

f. If a policy is issued, defense costs and expenses incurred will be applied against the deductible or retention amount as provided in the policy;

g. The Applicant's failure to report to its current insurance company:

(i) any claim made against it or any first party loss it discovered during the current policy term; or

(ii) any act, omission, or circumstances which the Applicant is aware of that may give rise to a claim or first party loss;

before expiration of the current policy may create a lack of coverage.

underwriting and claims activities. Copyright © 2019 CNA. All rights reserved.

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