New Plan A - Annual Policy

Policy Holder Account Information

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Policy Holder Trade / Service Information
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Only if required by state
Annual Membership - Policy Specification

Please specify your preferences from these options. Some may affect the final price of your purchase.

Your membership will provide you with insurance as an individual only. Often your landlord or place of work or trade show require that they be listed on your Certificate of Insurance as an Additional Benefit Holder specifically for your work. Additional Benefit Holder is not for other professional providers as they must have their own individual policy. There is a $10 charge for each additional insured. NOTICE: Additional Insureds must be added each year. They do not automatically carry over from your previous policy.


Product Liability Section (Add On)

The Product Liability Coverage that is included in this endorsement is intended for any products that is Manufactured, Sold, or Distribute as part of your business operations during the course of your services.

Policy Holder Contact Information
Policy Holder Mailing Address
Billing Address
Claim History

Have you had any liability claims, or are you aware of any incident(s) within the last five years that may result in a liability claim?

Terms & Conditions
By checking this box I accept the Excluded Modalities & Services in this policy.
By checking this box I accept the Terms & Conditions


Policies are 100% fully earned. No refunds will be given.

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