Verisk Strategic Alliances Vendor Information Form

Please note: This form is solely meant for engagements with vendors and not MGAs, MGUs, Agents, Brokers, etc. It is important to provide complete information requested on this form, such as project scope, correct licensed products, or timeline of the project. If incomplete, this may result in delays. If you have any questions about the form, please contact your Account Executive.

Step 1 of 3

Please complete a separate form for each vendor. Note: Vendor may be subject to an administrative fee.

1. This vendor will be developing: *

2. Your company (Insurer) will be providing the following ISO products to this vendor for this project:

Please note: You should only check off products that (1) you currently or are in the process of licensing and (2) will be shared with the 3rd party vendor. Adding products that you do not currently license may cause a delay in the processing of the VIF. If you have any questions regarding your licensed products, please contact your Account Executive.

Policy Administration/Rating
Extreme Event Modeling

Step 2 of 3

3. For LOCATION services, please check the services you currently license:
4. This vendor or consultant requires access to specific policy admin and rating information for the following lines of business on your behalf for this project (Note: if the vendor is working in different states for each line of business, please note that below. This section is only required for policy administration/rating products listed above, not underwriting).
5. How will ISO materials be delivered to this vendor or how will the connection be established? * Please note that vendors cannot access Underwriting products via ISOnet.
8. The product is:*
9. Where will the work be done? * (Please note: There are limitations/restrictions regarding 3rd parties accessing data off-shore for certain products. If you are working with an off-shore 3rd party vendor, please contact your Account Executive to discuss this.):
12. Where will the materials/data/connection be hosted?
14. Who will be supporting the system/application in Production? (Ex. If 3rd party off-shore vendor and has been approved for UAT access only, who will help support the client in Production?)
15. Who will be doing Production releases after the project/implementation is complete?

16. How long will you be working on this project with the vendor? (Please note: Standard term for consultant licenses is 6-12 months. If your project requires more time, we can extend the term for a reasonable amount of time based on the engagement.) *

Step 3 of 3

I am an authorized representative from the above insurer or MGA to certify that this is a complete and accurate statement of the work we are requesting from the above vendor. We require the vendor to use ISO products only as permitted by the terms and conditions of our license. We understand that we are responsible to Insurance Services Office, Inc. and its subsidiaries and affiliates for any vendor use or misuse of ISO products.