Application Forms

To obtain a quote:

The application is located below. Submit your application directly to HUB International / 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 review and approval of your completed application, you will receive a quotation by email, fax or mail (please indicate preference on application). If you accept our quotation, please make arrangements for your payment to reach our office PRIOR TO THE EVENT DATE. We accept credit cards, cashier's checks and money orders; no personal checks. PLEASE CALL US TO PAY BY CREDIT CARD. Upon receipt of your payment, a Certificate of Insurance will be emailed, faxed, or sent to you by mail.

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.