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Business Entity Information
Welcome! Once the following online enrollment process is complete, you will automatically receive proof of insurance via a Certificate of Insurance as well as a Confirmation Number. Please keep the Confirmation Number, as you will need this number to access your customized portal throughout the policy period, which includes the ability to secure Certificates of Insurance at your convenience.
Business Entity Name
i9 Sports Territory Location Name
Business Entity Address
City
State
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI
MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
PUERTO RICO
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
ZIP Code
Owner First Name
Owner Last Name
Phone
Owner Email Address
Number of Years in Operation
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
Desired Effective Date
Does your i9 Sports business entity own or operate a sports facility or field
Yes
No
Yes, I confirm that my business entity follows the abuse and molestation risk management program as set forth by i9 Sports
Continue
Help
Please feel free to reach out to the American Specialty service team with questions or if you need to update the information provided in the original enrollment.
Email
[email protected]
Phone
260-755-7296