Business name* What is the name of your business?
Flood rejection statement* Please retype the following statement in the space below to reject Flood insurance.
*I certify that I have been given the opportunity to purchase Flood insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it.
Earthquake rejection statement* Please retype the following statement in the space below to reject Earthquake insurance.
*I certify that I have been given the opportunity to purchase Earthquake insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it.
Hurricane / Wind / Hail rejection statement* Please retype the following statement in the space below to reject Hurricane, Wind and Hail insurance.
*I certify that I have been given the opportunity to purchase Hurricane, Wind, and Hail insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it.
Cyber rejection statement* Please retype the following statement in the space below to reject Cyber insurance.
*I certify that I have been given the opportunity to purchase Cyber insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it.
Commercial Excess Liability / Umbrella rejection statement* Please retype the following statement in the space below to reject Commercial Excess Liability / Umbrella insurance.
*I certify that I have been given the opportunity to purchase Commercial Excess Liability / Umbrella insurance and I have decided to reject this coverage and forego the protection it provides by not purchasing it.
