Wedding Liability Insurance Purchase

Step 1 of 4

Starting at $106

Your Name*

Email*

Phone Number*

Coverage Start Date*

Coverage End Date*

First & Last Name or Business Name/DBA (what policy will be under)*

Contact Address (you or your organization)*

Street Address Address Line 2 City State ZIP Code

Venue Location Name*

Venue Address*

Street Address Address Line 2 City State ZIP Code

Are additional insured(s) required by written contract?*

Additional Insured Terms*

I acknowledge that only venues/municipalities can be included as additional insured

1st Additional Insured Entity Name*

1st Additional Insured Entity Address*

Street Address Address Line 2 City State ZIP Code

2nd Additional Insured Entity Name*

2nd Additional Insured Entity Address*

Street Address Address Line 2 City State ZIP Code