| What date do you require coverage? If you currently have insurance this would be the expiry date of the current policy term. |
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| Preferred Method of Contact: |
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Complete 1 application for each location to be insured. Split the revenues estimates by location |
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| Do you lease or own your premise: |
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Your Equipment (including leased equipment), tools, and Leasehold/Unit Improvements are insured for the Replacement Cost New. |
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Stock is insured at your cost. Including dried cannabis, oils, edibles, concentrates, etc. |
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Stock is insured at your cost. Includes vape units, rolling papers, and other related stock that does not contain cannabis |
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| Building # of Stories: |
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| Is the building sprinklered: |
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| Is there a fire hydrant within 300 meters: |
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| Is there a fire hall within 8 kms: |
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| All security measures are operational during non-business hours: |
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| Any security guards or firearms on the premises: |
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| Do you have bollards to prevent ram-raiding and vehicle-ramming break-ins: |
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Include details of work being done and projected start and completion dates |
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Please provide type and year updated for roof, plumbing, heating, and electrical/wiring if the building is more than 20 years old. |
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We are looking for the name of the insurance company for this business, not the insurance brokerage. If not currently insured please advise "none" |
| Has your insurance ever been denied or canceled?: |
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| Please provide claims details in additional information section - date, description of loss, estimated amount paid. |
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Please provide claims details in additional information section - date, description of loss, estimated amount paid. |
| If you want a straight comparison to your current coverage, please upload a copy of your current policy |
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| To confirm you aren't a bot! |
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