REQUEST TO BE ADDED AS
"ADDITIONAL INSURED"

 

FIRST ORGANIZATION OR NAME TO BE ADDED AS "ADDITIONAL INSURED":
Organization or family name:
Street Address:
City, State, Zip Code:
Any other information needed to
identify "Additional Insured":
Email address to send certificate:

 

SECOND ORGANIZATION OR NAME TO BE ADDED AS "ADDITIONAL INSURED" (IF WANTED):
Organization or family name:
Street Address:
City, State, Zip Code:
Any other information needed to
identify "Additional Insured":
Email address to send certificate:

 

Please press the "Send Request" button below to send your information to us.

  There is a $40 per year charge to be included on Experiencing Imagination's $2MM aggregate policy. See policy for limits, deductibles and other underwriter specifications. Coverage applies only to equipment provided by Experiencing Imagination.

 

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