Travel Agent/Agency/Tour Operator Professional Liability Indication Form
 
 
 
 
 
 
Not available for accounts with losses in the past five years. If there is loss history, please complete the section below and submit details in a claim supplement.
 
 
 
 
Section 1 - About Your Business
 
 
 
 
Applicant First Name*
 
 
Last Name
 
 
 
Agent/Agency/Tour Operator Name*
 
 
 
State*
 
 
 
 
Email*
 
 
Phone*
 
 
 
 
 
 
Description of Operations*
 
 
 
 
 
 
Total Annual Gross Receipts*
 
 
 
 
 
 
 
Website (if applicable)