Small Business Insurance

Contact information
Your Name*
First Last
Your Business Name (If any)
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*

Add an Additional Insured?*
- Yes
$20 fee is charged for each eligible Additional Insured
Additional Insured Name*
Please ensure you have the exact way the name on the certificate should read. An Additional Insured is an entity which has an insurable interest on claims arising out of your negligence. The Additional Insured would be entitled to defense and indemnity under your policy with no responsibility for premium payments.
Additional Insured is:*
- Organizer and Promoter of Event
- Manager or Lessor of Premises
- Co-owner of Insured Premises
- Controlling Interest in this business
- Owner or Lessor of Leased Land
- Grantor of Franchise
- State/Political Subdivision for permits relating to Premises
Additional Insured address*
Street Address Address Line 2 City State ZIP Code
Comments
This field is for validation purposes and should be left unchanged.

Additional Insured Request

When an event, place of business, meeting facility, etc. may need to be named as an “Additional Insured” onto your coverage so that you can participate or set up, use the form on this page to request an Optional certificate.

The certificate will generally be emailed back out to you 24 to 48 hours after your request.

Call 913-231-4466 with any questions.

Small Business Insurance – Add Additional Insured

Contact information

Small Business Insurance

Additional Insured Request

RedSky Insurance