MJBizCon - Powers Insurance & Risk Management

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Cannabis Coverage Request

1Products

2Contact Info

3Location

4Documents

Hello! What type of cannabis operation are you?*
- Dispensary
- Cultivation
- Extraction / Manufacturing
- Processing / Copacking
- Testing
- Distribution
- Landlord
- Other
Check all that apply. You can tell us if there is something else you need a quote for in just a moment.

Primary Contact Name*
First Last
Phone*
Email*
Business Entity Name and DBA*

Insured Location Address*
Street Address Address Line 2 City State ZIP Code

This is not required, but if readily available, please upload your most current insurance policy coverage declarations pages in PDF format so we can see the exact coverage limits you'd like us to compare. These can be easily downloaded from your online profile with your current provider (if you have a login), or from your current agent.
Drop files here or

Max. file size: 39 MB.
If you have any other questions, comments or requests, please leave them here

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