Public Entity

PE Applicant Information Section

PDF icon PE Applicant Information Sec (1/13)

PE Commercial Automobile Section

PDF icon PE Commercial Automobile Sec (10/04)

PE Commercial Umbrella/Excess Liability Application

PDF icon PE Commercial Umbrella/Excess Liability App (10/04)

PE Convention/Civic Center Exposure Questionnaire Q
(Exhibition Buildings, Arenas, Etc.)

PDF icon PE Convention/Civic Center Exposure Quest Q (10/04)

PE Crime Information Section Supplement
(Complete in addition to Applicant Information Section)

PDF icon PE Crime Information Sec Supp (1/12)

PE Dams and Reservoirs Questionnaire M

PDF icon PE Dams and Reservoirs Quest M (10/04)

PE Day Care Questionnaire C

PDF icon PE Day Care Quest C (10/04)

PE Electric Utility Questionnaire F

PDF icon PE Electric Utility Quest F (10/04)

PE Emergency Dispatchers Liability Section

PDF icon PE Emergency Dispatchers Liability Sec (10/04)

PE Employment Practices Liability (Claims Made) Section

PDF icon PE Employment Practices Liability (Claims Made) Sec (2/13)

PE Firefighters Professional Liability Section

PDF icon PE Firefighters Professional Liability Sec (10/04)

PE Gas Utility Questionnaire G

PDF icon PE Gas Utility Quest G (10/04)

PE General Liability Section

PDF icon PE General Liability Sec (10/04)

PE Landfill/Dump/Refuse Site/Incinerator Questionnaire D

PDF icon PE Landfill/Dump/Refuse Site/Incinerator Quest D (10/04)

PE Law Enforcement Liability Section

PDF icon PE Law Enforcement Liability Sec (9/09)

PE Miscellaneous Exposure Questionnaire P

PDF icon PE Miscellaneous Exposure Quest P (10/04)

PE Port/Transportation/Airport Authorities Questionnaire N

PDF icon PE Port/Transportation/Airport Authorities Quest N (10/04)

PE Professional Renewal Questionnaire

PDF icon PE Professional Renewal Quest (8/09)

PE Property and Allied Lines Information Section
(Complete in addition to Applicant Information Section)

PDF icon PE Property and Allied Lines Information Sec (1/12)

PE Property and Casualty Renewal Application

PDF icon PE Property and Casualty Renewal App (1/13)

PE Public Housing Authority Questionnaire H

PDF icon PE Public Housing Authority Quest H (10/04)

PE Public Officials Liability (Claims Made) Section

PDF icon PE Public Officials Liability (Claims Made) Sec (10/09)

PE Recreational Activities Questionnaire K

PDF icon PE Recreational Activities Quest K (2/09)

PE Schools Questionnaire J

PDF icon PE Schools Quest J (10/04)

PE Sewer/Water Utility Questionnaire E

PDF icon PE Sewer/Water Utility Quest E (10/04)

PE Special Events Questionnaire B
(Carnivals, Fairs, Parades, Etc.)

PDF icon PE Special Events Quest B (10/04)

PE Streets/Roads/Highways/Bridges Questionnaire A

PDF icon PE Streets/Roads/Highways/Bridges Quest A (10/04)

About Us

Roush Insurance Services, Inc. is a wholesale general insurance agency that has been in business since 1990. We offer licensed insurance agents access to the excess and specialty market for risks domiciled in Indiana, Illinois and Ohio.

Industry Links

Our memberships in WSIA, PIA of IN, IIA of IN and IIA of IL enable us to stay abreast of industry developments and better serve your insurance needs.

Contact Us

Roush Insurance Services, Inc.
18077 River Road, Suite 107
Noblesville, IN 46062-8311
Toll Free: (800) 752-8402
Phone: (317) 776-6880
Fax: (317) 776-6891
Submissions: quote@roushins.com
Claims: claim@roushins.com
Accounting: accounting@roushins.com
Information: info@roushins.com