Cyber Liablitiy Policy Required Questions

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The following questions must be answered to complete the Cyber Liability Coverage you have purchased for your organization.

Important: If your organization does not have anti-virus software (including Macs) on computers used on behalf of the organization and unsecured routers/firewalls are used to access the internet, your organization cannot be covered by this policy.

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Organization Name(Required)

Name of person completing this form:(Required)

First Last

Email(Required)

Does your organization have anti-virus software installed and updated quarterly on all computers and are firewalls (secure routers) in place when data is accessed?(Required)

These items are required to be in place to covered through the Cyber liability policy. Mac and PC users must have some type of anti-virus software.

Does your organization or an outsourced firm, back up your data and systems at least once a week, and store these backups in an offsite location?(Required)

Outsourcing may include your event registration company, your cloud based-file system, etc.

Within the last 5 years, has your organization suffered any system intrusions, tampering, virus or malicious code attacks, loss of data, loss of portable media, hacking incidents, extortion attempts, or data theft, resulting in a claim in excess of $25,000 that would be covered by this insurance?(Required)

After inquiry of the "Control Group", as defined, are "You" aware of any or have any grounds for suspecting any circumstances which might give rise to a claim?(Required)

"Control Group" means the board of director members, executive officers, Chief Technology Officer, Chief Information Officer, Risk Manager, and General Counsel or their functional equivalents of “Your Organization”. This does not include any administrative staff who work in the offices of these named positions.

Please provide your prior fiscal year-end (FYE) GROSS REVENUE:(Required)

Enter Gross Revenue, not net profit/loss. Enter the full number value. i.e $1,000,000. Do not use abbreviated values.

Cyber Liablitiy Policy Required Questions

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