Insurance Application

Application for Event Insurance

For your event to be posted you must fill out the application form and purchase event insurance. After you complete the form and submit it, the special worker will call you at the number you have provided during regular office hours and will go over any entries you were uncertain of or, are incomplete, and take your payment over the phone. We offer this as a convenience with the alternative method of doing it in person at the Regional Service Office in Monrovia.
🤔If you choose to secure event insurance from an outside source, you must provide your Certificate of Insurance prior to your event being posted.

Name(Required)
MM slash DD slash YYYY

Information for Certificate

The name of your venue.
Address(Required)
The address of your venue.
Add email address if there is someone you were directed to provide this to.
Required Coverage(Required)
Special Endorsement
If you have additional insured needs (uncommon).

Handling Instructions

Email to certificate holder here
Put in your email address.
If your venue requires any additional needs you probably already know.
Payment(Required)
Call during office hours and speak to the special worker.
Use this link to call the special worker now. You will be able to finalize your insurance application and provide payment at this time to avoid having to follow up later. Call Us Now