Skip to content
Accessibility info
Free Insurance Quotes
602-745-2886
Our Blog
RightSure Insurance Group
BETA TEST PAGE 2 CAMRA
MITA/CARMA Quick Quote Form - Dispensary/Retail
+
RIGHTSURE
INSURANCE
MITA/CARMA Quick Quote Form
Dispensary/Retail Insurance Application
Thank you! Your form has been submitted successfully. We'll contact you shortly.
Please fill out all required fields before submitting.
Business Information
Business Name
*
Business Address
*
Phone Number
*
Email
*
Owner/Applicant Name
*
Business FEIN
*
Are you a new Venture?
*
Yes
No
Are you Licensed?
*
Yes
No
Year Established
*
Annual Sales
*
Do you currently have insurance?
*
Yes
No
New Policy Effective Date
*
Liability Type
Select Liability Type
*
-- Select One --
General Liability
Product Liability
Property
Excess Liability
Property Information
Property Status
*
Own
Rent
Construction Type
*
-- Select One --
Frame
Joisted Masonry
Non-Combustible
Masonry Non-Combustible
Fire Resistive
Building Amount
TIB (Tenant Improvements & Betterments)
Equipment
BI (Business Interruption)
Finished Stock
Additional Information
Additional Comments
Submit Application
Ready to Save?
Contact us for a no-obligation insurance quote.
Get a Quote
