Application Forms

To obtain a quote:

The application is located below. Submit your application directly to Diversified Risk Insurance Brokers and a quote will be sent to you, usually within 72 hours of application receipt.

Submission of this application does not guarantee coverage. Completion of these forms confirms your desire to obtain insurance coverage through the Special Event Liability Group Insurance Trust. Coverage will be bound for your requested dates upon receipt and approval of your completed application and payment of premium.

Insurance coverage can only be bound by the Administrator of the Purchasing Group, after review and approval.

After receiving a quotation, please make arrangements for your payment to reach our office at least 10 days prior to the event date. Upon receipt of payment (must be a cashier's check or money order - no personal checks accepted) and approval of your completed application, a certificate of insurance will be faxed or emailed to you. If you do not have fax or email capability, then our quotation will be mailed to you.

Note: We are unable to offer you a quote or indication over the phone. Eligibility and premium cannot be determined without the details outlined in the application.