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    Contact Information:
    Thank you for visiting TSLA, a non-profit, trade association of excess and surplus lines brokerage and underwriting professionals. If you would like more information about our association and membership benefits, please contact us at your convenience:
    Great Hills Corporate Center
    9020-I Capital of TX Hwy N., Suite 370
    Austin, TX 78759
    Info Request Form

    TSLA 2017 Membership Roster and Product Guide

    Voting and Provisional Members Listing Info


    Coverage Listings

    Use this online form to add your listing(s) to the 2017 TSLA Product Guide. The deadline to submit your information for inclusion in the directory is Monday, March 06, 2017.

    You may have 5 FREE Coverage Listings (Voting/Provisional members only)

    • Advertisers receive more FREE coverage listings (see advertising section below for more information.)
    • Extra Coverage Listings: $10.00 each
    • You may pay online by Credit Card via this Secure form

    Advertisers - Added Bonus!*

    • More FREE coverage listings
    • Free Banner Ad on the TSLA website
      (Banner ad is created by TSLA using content from ad you submit at no additional cost)

    *see advertising section below for more information


    This Online Application is on a Secure
    Server. Click on the seal on the left
    for more information on the
    certificate's authentication.

    Please complete the sections below:

    General Information
    This section must be completed in order to register online
    Member Firm Name:   
    Contact Name:  
    Phone #:     Toll Free #:
    City/State/Zip:  ,
    Email Address:  
    Web Site Address:  


    Advertising Information
    If you wish to place an ad in the Product Guide, use this section
    to select your ad size and number of additional Free Listings.
                            Click here if you want to use the same Ad you used in our 2016 directory.
                                  (You must STILL select an ad size below in order to calculate costs.)
    in-COLOR Make your ad stand out in the crowd by adding some COLOR! Color for all ad sizes is a flat fee of $750, so why not upgrade to a full page, color ad?! Your full page, color ad will stand out among the rest! Full page ad ($915), plus color fee ($750) is only $1665.00!
    Select your Ad Size below:

    Full Page -- 8 1/2 x 11
    *25 Free Listings

    *Free Banner Ad 
    on website      

    Half Page -- 8 1/2 x 5 1/2
    *20 Free Listings

    *Free Banner Ad 
    on website      

    Half Page -- 4 3/4 x 7 1/2
    *20 Free Listings

    *Free Banner Ad 
    on website      

    1/4 Page -- 4 3/4 x 3 3/4
    *15 Free Listings

    *Free Banner Ad 
    on website      

    1/4 Page -- 2 1/4 x 7 1/2
    *15 Free Listings

    *Free Banner Ad 
    on website      
    Click Here to cancel your ad selection
      Check here if using a color ad. ($750 additional)

    *The number of FREE listings include the five that are given to each member.

    New ads should be emailed to becky.harper@austex.com.
    Mechanical Requirements
  • PDF's: *High Resolution (300 dpi) with fonts embedded

  • TIF's: *High Resolution (300 dpi) to size

  • Trim Size: 8 1/2" x 11"

  • Full Page Bleed: 8 3/4" x 11 1/4"

  • Submitted Artwork: Must be complete with bleeds & crop marks and all text must be at least 3/8" distance from the trim line. For artwork to bleed, please add 1/8 on all sides.
  • Camera Ready Art*: Material given to the printer that needs no further work before being passed on to the printing department. Any changes that need to be made to ads being repeated will be charged additionally a flat $65 fee to be billed later by TSLA.
    TSLA Logo
    If you would like the TSLA logo to use in your ads, please contact Jean Patterson.

    Contact Jean for TSLA Logo: jptsla@tsla.org.


    Coverage Listings
    For Voting/Provisional members only
    Please select up to 5 free listings below, and any
    additional coverages you wish to list for only $10.00 each:
    NOTE that some coverage listings have changed since last year, so you need to select ALL listings you want for the 2017 Directory below.
    Select your Coverages below:
         Auto, Commercial
     Auto Liability
     Contingent Auto Leasing
     Daily Auto Rental
     Dump, Sand & Gravel Trucks
     Excess Auto
     Garbage Trucks
     Gasoline/Diesel Fuel Haulers
     Hazardous Materials Hauling
     Hired & Non-Owned Liability
     Physical Damage
     Repossessed Vehicles
     Tow Trucks (Including Repo)

         Auto, Public
     Social Service

         Auto, Truckers
     Bob Tail or Dead Head
     Motor Truck Cargo
     Physical Damage
     Trucks, Intermediate Haul
     Trucks, Long Haul
     Trucks, Short Haul

     General Aviation - Property/Liability
     Products Liability
     Service Providers

     License and Permit

     Crane & Rigging
     Project Specific
     Residential Contractors
     Roofing Contractors- Residential/Commercial
     Utility Contractors

         Directors & Officers Liability
     Financial Institutions
     For Profit Entities
     Initial Public Offerings
     Not for Profit Organizations

     Employment Related Practices

     Film Negative
     Film & TV Producers Indemnity

     Asbestos Abatement
     Contractors Pollution Liability
     Environmental Consultant
     Environmental Impairment Liability
     Hazardous Waste Storage and Disposal Facilities
     Lead Abatement
     Underground Storage Tanks

     Equestrian Risks

         Excess/Umbrella Liability
     Excess Liability
     Excess Malpractice/Professional

     Farms - Commercial Risks

     Foreign Coverages

     Dealers, New
     Dealers, Used
     Garagekeepers Legal Liability/Dealers Open Lot
     Motorcycle Dealers
     Motorhome/RV Dealers
     Non-Dealers/Repair Shop
     Valet Parking

         Inland Marine
     Air Cargo
     Arts & Antiques
     Builder's Risk/Installation Floater
     Electronic Data Policy
     Equipment Dealers
     Equipment Floaters
     Fine Arts Floater
     Jeweler's Block
     Logging Equipment
     Miscellaneous Property Floaters
     Motor Truck Cargo

     Liquor Liability

         Marine, Wet
     Boat Dealer/Repair
     Hull and P&I, Commercial
     Marina Operators
     Passenger Vessels
     Wharfingers/Shiprepairers/Stevedores, etc.

     Assisted Living Centers
     Excess Liability
     Medical Laboratory
     Miscellaneous Healthcare Professionals
     Nursing/Convalescent Homes
     Out Patient Clinics

     Ocean Cargo

         Oil & Gas
     Alternative Energy
     Control of Well/OEE
     Drilling Contractors
     Energy Consultants
     Lease Operators/Non-Operators
     Liquefied Petroleum Gas Dealers
     Offshore Contractors & Service Risks
     Oil Field Property
     Pipeline Liability
     Refinery/Petrochemical Risks
     Rig Physical Damage
     Salt Water Disposal Wells
     Service Contractors

         Personal Lines
     Antique, Classic, High Value Autos
     Auto Liability/Physical Damage
     Contents Only
     Dwelling Fire
     Excess Personal Auto Liability
     High Value Homeowners
     Homeowners (A,B,C)
     Jet Ski
     Mobile/Manufactured Homes
     Personal Articles Floater
     Umbrella/Excess Liability

         Products Liability
     Medical Products
     Other Product Liability
     Products Recall

         Professional Liability/Errors & Omissions (non-medical)
     Architects & Engineers
     Consultants, Miscellaneous
     Insurance Agents/Brokers/MGA
     Miscellaneous Classes
     Mortician/Funeral Director
     Property Managers E&O

         Property, Commercial
     Bed & Breakfast/Lodging
     Difference In Conditions
     Forced Placed/Foreclosure
     Mobile Home Park
     Property Management Companies
     Real Estate Development

         Public Entities
     Law Enforcement Officers
     Municipalities, Liability
     Public Officials Liability
     School Board Legal Liability
     School/Municipal Property Schedules
     Utility Districts Liability

         Railroad Risks
     Railroad Protective

     Adult Day Care
     Day Care Center/Nurseries
     Detective/ Patrol/ Security
     Health Club/Tanning Salon

         Special Events
     Event Cancellation
     Event Liability
     Prize Indemnity
     Rebate Insurance
     Weather / Rain coverage

         Sports and Recreation
     Amusement Parks
     Athletic Teams/Leagues
     Driving Ranges/Golf Course
     Dude Ranches
     Hunting Clubs/Leases
     Outfitters & Guides

     Computer Consultants/EDP Errors & Omissions
     Data Privacy & Network Security
     High Technology Projects
     High Tech Inland Marine
     Products Liability
     Software Design/Development
     Website/Internet Development

         Worker's Compensation & Related
     Defense Base Act
     Excess Employers Indemnity
     Excess Maritime Employers Liability
     Excess Worker's Compensation
     Maritime Employers Liability
     Non-Subscriber Policies
     Occupational Accident
     United States Longshoremen and Harbor Workers Compensation (USL&H)
     Worker's Compensation


    Fees / Costs
      # of Listings from
      Last Year:
      # of Listings You
      # of Free Listings:  
      # of Additional Coverages:  
      (x) $10.00 ea. = $
      Advertisement: $
      Color Ad Fee: $
      Total Amount Due: $

     Please Note: Some browsers may not automatically 
     update all calculations, so please click on the "Verify 
     Calculation" button below once all listings and/or 
     advertising options have been selected. 

    If "Total Amount Due" is $0, you may skip the Payment section below...


    Payment Method:  Ad/Listings are comp   Invoice Me   Check   Credit Card
     » If payment is "Ad/Listings are comp", please skip the remaining payment section below.
     » If payment is "Invoice Me", you will receive an invoice via email. Please remit payment by
        check using the instructions below for payment by "Check."
     » If payment is by "Check", please make check payable to "TSLA" in the amount due listed
        above and mail to:
    9020-I Capital of Texas Hwy N.
    Suite 370
    Austin, TX 78759
     » If payment is by "Credit Card", please complete the credit card section below:
    (* all fields are required below if payment is by credit card)
    Credit Card (CC) Type:  
    Credit Card #:  
    CVV / CVC Code:    What's This?
    Expiration Date:   (mmyy)
    Name on Card:  First:  Last:
    Check here
    if same address
    you entered at
    top of this form
    CC Billing Address:  
    CC Billing City:     Billing State:
    CC Billing Zip Code:  
    CC Billing Phone #:  


    Payment Receipt Email Address
    Enter the email address that you would like your payment receipt sent to below:
    Payment Receipt Email Address:  


    Additional Comments
    Please enter any additional comments in regards to your listings/advertising order. You may also use
    this area to include requested information from above where there was not enough space(s) to enter.

    By pressing Submit below, you are agreeing to have TSLA bill the above listed credit card for listings and/or advertising fees for the 2017 Membership Roster and Product Guide. Please review your information for accuracy before submitting this form. TSLA is not responsible for any incorrect information entered into this form.

    You must check the box below in order to submit your registration:
    I agree to allow TSLA to bill my credit card (if applicable) and have reviewed all information I have provided for accuracy.


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