"*" indicates required fields

The Business Name (not the Formal Entity Name)
The type of formal business entity.
(Full legal business name. Example Tattoo the Zoo, LLC)
Your Name*
Is this a Renewal Application?*
Email*
Where you can receive private information
May we text you?*
Consent is not required as a condition of purchase. Message frequency will vary. Message and data rates may apply. Reply HELP for help or STOP to cancel. View our Privacy Policy.
How would you describe your business?*
Not required, but we may need it in the future
Your Birthdate
So we can celebrate with you!
Are you currently insured with another company?
Location Address*
Let your agent know if you lease multiple locations.
Mailing Address*
Do you work at multiple locations WITH a lease agreement?
Only select yes IF there is a Signed Lease in your name. Our policy follows you throughout America automatically.
What is your current Business Location(s) Situation?*
Do you have W-2 Employees?*
Who Receives W-2 Payroll?
Approximate, in the next 12 Months.
Primary Services Offered*
Check all that apply that you / yourself are performing. Include direct W2's or 1099's working within your business. Do not include services offered by room or booth renters (separate entities).
We do not offer coverage to anyone without proper training for Tiny Tattoos. Please seek a extended apprenticeship or training.
We do not offer coverage without a minimum of 100 hours of fundamental training. We require you to present training credentials.
This is Gross Revenue that you would report to the IRS. Only for the "Act of", (the actual Service offered) Do NOT include 1099 Commission or Tips that artists keep, or revenue from Merch or Retail sales. Please ask your agent for clarification.
Offer Additional Services?*
Check all that apply that you / yourself are performing. Include direct W2's or 1099's working within your business. Do not include services offered by room or booth renters (separate entities).
This is Gross Revenue that you would report to the IRS. Only for the "Act of", (the actual Service offered) Do NOT include 1099 Commission or Tips that artists keep, or revenue from Merch or Retail sales. Please ask your agent for clarification.
Do you sell Retail, Merch, Supplies?*
This is Gross Revenue that you would report to the IRS. Liability coverage for retail sold goods in case of suit against you for damages from product sold. We do not cover manufactured, relabeled or handmade products. Ask your agent for a product liability policy quote.
Do you Offer Training or Instruction?
Types of Training or Instruction*
This is the Gross Revenue you would report to the IRS.
Could you please share more information about what you're teaching and any structural information you have? We want to make sure that you are covered properly.
Our GL Limit is $2,000,000 Agg /$1,000,000 per Occ. Want to raise it to $3,000,000 /$2,000,000 for an Additional $750.00 per year?*
We provide $500,000 in Professional Liability. Would you like to raise it to $1,000,000 for an Additional $350 per year?*
Does your Landlord or Property Manager Require a Certificate of Insurance that must have a Waiver of Subrogation?*
If you are unsure, please upload that page of your lease at the end of this application, or ask your agent.
Does your Landlord or Property Manager Require a Certificate of Insurance that must have Primary Wording?*
If you are unsure, please upload that page of your lease at the end of this application, or ask your agent.
Do you want coverage for contents at your Business Location?*
Decor, Art, Furniture, Antiques, Reference Material, Merchandise and Retail Stock In the case of Fire, Vandalism, Theft?
If you are within an Eastern Coastal or Gulf Coastal State, do you want coverage for wind if available?*
The carrier issued recent underwriting changes. Please speak with your agent about coverage for property damage caused by gusty events in your State. Wind is not offered in all States.
I understand and agree that I when I select "Liability Only" it is General and Professional Liability for my services, and NOT coverage for my business contents, furniture, tenant glass, stock, merchandise, papers, records etc.*
Do you own the building?*
Do you need coverage for the entire building?
Have you made any "Tenant Improvements"?*
This includes the floors, lighting, molding, cabinetry etc. anything "attached" to your studio.
To Date, what is the cost of the Improvements YOU have made to your space? We want to put it back the way it was after a loss such as fire, smoke damage etc.
Do you need Tenant Glass Coverage?*
If you are responsible for the glass breakage or damage, select yes. Glass is not automatically covered; it must be added.
Our Property Coverage is Replacement Value. How much would you need to replace Furniture, Art, Computers, iPads, supplies, stock, merch, appliances, etc?
Do you want Business Income Coverage?*
This amount is divided by three months for a physical loss longer than 72 hours, that prevents you from performing services. Proof of lost income is required.
How much income would you need, EACH month for 3 months if your workspace was physically damaged and you could not work/generate an income?
Do you want Coverage for your Equipment and Supplies taken "off site"?*
Conventions, Education, Guest Spotting, etc. (Theft and Damage while away from the studio)
Maximum Limit of $20,000
Security features. (Check all that apply)*
Theft coverage is subject to a working central alarm system that's operational, notifies the 1st Responders and active at the time of loss.
Describe your Business Location within the Building*
**Street level means your business provides goods and services adjacent to, visible from, and accessible from the sidewalk.
Has the Prop Manager performed Inspections or updates to your leased location within the last 20 years?*
Please enter the Year each was Updated OR Inspected. Please ask the Property Manager or Landlord if you aren't sure, this information is Critical for the best Property Coverage available.
Approximate Year
Approximate Year
Approximate Year
Approximate Year
Are you concerned about Discharge From Sewer, Drain or Sump damage?*
Do you have Fine Art inside your location?
Are you concerned about Employee theft?
Do you offer beer or wine?*
Do you comply with all City, County, Health and State Ordinances?*
This is a condition of our policy
Have you ever had a Health Department Violation?*
Stay current on Bloodborne Pathogen education?*
This is a condition of our policy
Do you obtain a signed release form for each client?*
This is a condition of our policy
How long do you keep signed forms on file?*
We encourage cyber safety precautions for digital release forms and privacy precautions with paper forms.
Do you check, photocopy and keep on file the client's ID?*
Per your state and county health dept guidelines. This is mandatory in California.
Do you provide "After Care Info" after each procedure?*
This is a condition of our policy
Are you prepared to handle fainting or nauseated patrons?*
Are you 100% single use?*
Do you always use barriers and cord wraps?*
This is a condition of our policy
Add Cyber Liability / Data Breach Coverage for $50 per year?*
$25,000 Sub Limit (Breach of your Clients Data)
Add Communicable Disease Coverage for $150 per year?*
$100,000 Sub Limit. Ideal for Tattooers, Piercers, Microbladers or Machine work of any type.
Add Assault and Battery Coverage for an Additional $200 per year?*
$200,000 Aggregate Limit This coverage is primarily for studios with exposures to vagrants, near bars or heavy public foot traffic outside it's doors.
Add Sexual Abuse Misconduct Coverage for an Additional $200 per year?*
$200,000 Sub Limit, Select if you are worried about being accused of touching someone inappropriately or perform areola or genital piercings.
Does staff use their own cars for bank / supply / food runs?*
Do you want coverage in case they have an accident in their vehicle?*
Business owners can be responsible for damages if someone gets in an accident while running errands.
Does your Landlord require a higher Premise Damage limit?*
We provide $100,000 automatically.
Do you want Terrorism coverage?*
Only certified acts are eligible for coverage through TRIA. A certified terrorism event is classified by the Secretary of the Treasury, Secretary of State AND the Attorney General. PLEASE ask your agent to explain this coverage before purchasing.
Do you want to cover your business items from theft and damage.
Perfect for Booth or Room renters that bring their machines and supplies to and from the space for appointments. Coverage for theft and damage.
Do you manufacture, re-label or repackage products to sell under your own name?*
If so, you need a Product Liability policy.
Our Program does NOT include product liability. Agents can help you find coverage with an alternative carrier.
Have you had a policy cancel for Non Payment in the past 12 months?*
Have you had any claims or losses in the last 5 years?*

Landlord / Property Manager / Additional Insured Certificate Information

Landlord Additional Insured Certificates are complimentary. Waiver of Subrogation and Primary Wording endorsements are $50.00 Each
Do you Need an Additional Insured Certificate?*
Please provide the most updated information for our records.
Want us to email it directly to them?*
Your Agent will email the Certificate of Insurance
Property Manager/Landlord Address*
Address to be Listed on Certificate of Insurance. Usually on the Lease Agreement.
Anything you want us to know!
Loss Runs, Other Company Quotes, Claim Documents, Additional Insured Requirements
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 12 MB.
    The above information is accurate, true to my knowledge.*
    I affirm and certify that all the information and answers to questions herein are complete, true, and correct to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void and will be cause for cancellation, whenever discovered.
    Consent*
    Like most insurance agencies, we use information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance, set you up for monthly payments (if chosen). New or updated information may be used to calculate your renewal premium.
    MM slash DD slash YYYY
    This field is for validation purposes and should be left unchanged.