Please add the name of Principal Insured in First Line and all the Companies which you want as Additional Insured from second line*
Complete Address where Business is Done*
Website
Year Business Started
Health Canada Licence #
Type of ACMPR License
Describe the procedures, processes, or practices of the businesses – manufacturer, processor, indoor grow, outdoor grow, retail, dispensary, lab, and delivery.
Replacement Value of Buildings, Contents, General Liability Limit Required
Your small story which is NOT on your website. (Why? Insurance Companies charge for what they do not know. This is where you tell all the insurance companies about the great things you do which would decrease the possibility of different losses in your business. You also tell them how you are different from your competitors.The more you tell the less is the premium.)
Revenue for last three Years
Total Employees*
Name, Email and Phone Number of person handling insurance
Claims in lat 10 Years
Email*
Phone*
