Confirmation & Submission | Indoor Inflatables Insurance App

Helpful Tip: If you are running out of time, simply finish the current page & click next. We will email you a link to complete the application where you left off!

Company Info
General Info
Operations
Rentals
Abuse
Auto
Property
Equipment
Fraud Page
Confirmation

NOTE: Remember not to hit your back button or your refresh button so that you do not accidentally erase or wipe out any type of information that you have typed in.
ADDITIONAL INTERESTS
1) Name:
Landlord Loss Payee Mortgagee
Mailing Address
Mailing address:
City:
State:
Zip code:

2) Name:
Landlord Loss Payee Mortgagee
Mailing Address
Mailing address:
City:
State:
Zip code:

Section 10b: Insurance Information
Information for General Liability:
Insurance comp. name:
Date policy expires:
Expiring Premium: $

Information for Umbrella:
Insurance comp. name:
Date policy expires:
Premium: $

Information for Workers Compensation:
Insurance comp. name:
Date policy expires:
Premium: $

LIABILITY CLAIMS INFORMATION:
How many claims in the last 5 years:

Please make sure that you have completed everything to the best of your knowledge before going to the next page.

ADDITIONAL INTERESTS

Mailing Address

Mailing Address