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Agencies may use the forms below as a basis for developing their own forms.

Please remember: Every agency is unique. Therefore, these forms should be modified to fit your agency's needs. Where possible, we have identified the form's author, but in some instances we were not able to determine from where the checklist originated.

Submission/Coverage Checklists


Additional Resource (this will take you to another website): The International Risk Management Institute offers an Exposure Survey Questionnaire and IRMI Insurance Checklists. Click on to learn more.



These forms can be important tools to help minimize E&O claims, but the use of these forms does not guarantee E&O claims will not be incurred.

Also, no form can cover every possible exposure and new exposures and coverages frequently arise, so a form should be reviewed and revised periodically.


These forms may assist in improving the quality of an agency's services. However, neither Chris Burand nor Burand & Associates, LLC guarantee that these forms will result in either improved operations or a loss free E&O experience.

Company Checklists
HR Forms

Don Phin, a top consultant on workplace relations, provides a variety of free materials on his Web site. Check out for a comprehensive list of Free Tools.

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