Home » General Liability and Professional Liability Application

Begin the general liability and professional liability application.

Get Started

Get in Touch

General Liability Professional Liability Application - View of Group of Business People Sitting Around a Table in a Corporate Meeting Room

Home » General Liability and Professional Liability Application

DSP Insurance Services, a ConferenceDirect Preferred Partner.

General Liability and Professional Liability Applicant Information

"*" indicates required fields

Step 1 of 4

25%

Name*

First Name* Last Name*

Business Name*

Name policy will be issued under.

Business Address*

Street Address* Address Line 2 City* State/Prov./Region* ZIP/Postal* Country*

Business County

Name policy will be issued under.

Phone Number*

Email*

Business Information

Is Your Business Operated Out of Your Home?*

Yes

Additional Locations*

Other than the business address provided, how many additional locations does your business own or rent?

What Best Describes Your Business' Ownership Structure?*

Number of Employees*

Including yourself, how many full-time, part-time, and temporary employees does your business have? (Do not include subcontractors.)

Do You or Your Business Supply, Manufacture, or Distribute Any Tangible Goods Products?*

Yes

Does Your Business Perform Any Design, Construction, Installation, Removal, Or Physical Repair of Any Property or Tangible Goods?*

Yes

Do You Currently Have an Insurance Policy In Effect for the Coverage Requested?*

Yes

Prefer Not to Answer

Coverage Start Date*

MM slash DD slash YYYY Coverage Start Date*

Coverage start date. Can be today or in the future.

Your Business

Does Your Business Only Host or Conduct Events for Itself?*

Yes

What Type of Events Are Primarily Planned or Promoted by Your Business?*

Catered Events

Charitable Events

Competitions

Concerts

Conventions

Corporate Events/Meetings

Festivals

Fundraisers

Government-Sponsored Events (Federal)

Government-Sponsored Events (State, Local, Foreign)

Political Events/Conventions/Fundraisers

Social Affairs/Weddings/Parties

Other

Does Your Business Promote Media, Artist, or Entertainers on Behalf of or for Any Entertainment, Publishing, Music, Internet, or Media Company?*

Yes

Not Applicable

Do You Maintain Current and Valid Professional Certifications or Designations as Required or Recognized by Industry Standards?*

Yes

Additional Business Information

Approximately When Did Your Business Begin?*

Estimated Payroll Expense*

For the next 12 months, what is your estimated payroll expense for yourself, your full time, part-time, and temporary employees? (Do not include sub-contractors.)

Estimated Gross Sales (Current Year End Estimated Revenue)*

What are your business’s estimated gross sales during the next 12 months? Do not include conferences booked further than 1 year out.

Estimated Gross Sales (Largest Customer) - Current Year Revenue*

During the next 12 months, what are the estimated gross sales you will earn from your largest customer? Do not include conferences booked further than 1 year out.

Does Your Business Use a Written Contract or Statement of Work?*

Initials*

This field is for validation purposes and should be left unchanged.

Live, expert help available M-F,
8AM – 8PM CST.
Call 630-890-2605

Contact DSP Insurance Services

Headquartered in Schaumburg, IL

We are proud to serve over 2,000 clients around the globe.

847-934-6100
info@dspins.com
847-934-6186 fax

Prefer to speak with someone from DSP Insurance Services?
Contact us directly.

Insurance Solutions

Business Insurance
Insurance by Industry
Employee Benefits
Personal Insurance
Explore Interactive Graphics
Safety Consulting
Custom Insurance Benchmarking

About DSP Insurance Services

About Our Agency
Meet Our Team
Read Our Reviews
We Are Independent
Join Our Team
Blog

Get Help

Report a Claim
Request Auto ID Card
Request a Certificate
Request a Bond
Policy Review
Request Policy Change
Client Login

1900 E. Golf Road
Suite 650
Schaumburg, IL 60173

info@dspins.com
847-934-6100
847-934-6186 fax

Experience the Value of an Independent Agency

Promising stability. Providing peace of mind. Caring about each client individually. This is more than what we do every day. It’s why we come in every day. Because at DSP Insurance Services, our future is yours.

We are licensed in the United States, Canada, and Mexico, as well as Europe, Asia, Australia, and around the globe.