Please complete the below form & we’ll contact you with more information. If you are unsure about some of the answers, no worries - just fill out as best you can and we’ll help you as needed.

Name *
Name
Mailing address
Mailing address
Type Of Business
Type of Operation
If New Venture: do any of the principals have a minimum of 1 year in the cannabis industry?
Have you been cancelled or denied commercial insurance?
Have you had any prior liability and or property claims or losses in the past 5 years?
Have you or any owner of the company been convicted of a felony or DUI in the last 10 years?
Are you in compliance with all local & state laws regarding the manufacture, control, dispensing of cannabis?
Do you currently hold a cannabis license/permit or expect to be licensed/permitted?
Which type of insurance do you need?