1 1 Nutra Product Application
2 2 Documents
3 3 Payment

Nutra Products Insurance Application (simplified UW)

Sorry, we don't have availability to purchase it online, but we are working on it! In the meantime, please submit quote for underwriting and we’ll reach out with any remaining questions!
This field is required

This policy will go into force on the start date and stay in force for 12 months.

Payments for this policy will stay in effect until cancelled.

$
Your application will be submitted for underwriting.
Your application cannot be completed online.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
$
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.
Your application will be submitted for underwriting.

Nearly 1 in 4 businesses have experienced a cybersecurity event. If you collect and/or store customer and financial data, we strongly advise adding Cyber Liability Coverage for greater protection and peace of mind.

Your application will be submitted for underwriting.
Your application will be submitted for underwriting.

Manufacturing Questions

Select an option
This field is required
Select an option
Select an option
Select an option
Select an option
Select an option
This field is required
Select an option
Select an option
Select an option
Select an option
Select an option
Select an option
Select an option

Insurance & Claim Questions

Select an option
This field is required
This field is required
This field is required
This field is required
Select an option
Select an option
Select an option
Excluded Products
Select an option
UW will review the policy

Business information

This field is required
This field is required
Business name - Only letters(A-Z), numbers(0-9), &(ampersand), -(hyphen), '(apostrophe), .(dot), comma, ()brackets, spaces, ‘ ’(curly apostrophes), /(slash), :(colon), ;(semicolon) are allowed.
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
Please provide your full name under mailing address.
A business you own and operate, not a business that employs you.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
Invalid phone
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.

Primary Business Activity

Secondary Business Activities

This field is required
This field is required

Physical Address

This field is required
Name can be between 2 and 70 characters long and can contain letters, hyphens, commas, dots, apostrophes and spaces
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
Name can be between 2 and 70 characters long and can contain letters, hyphens, commas, dots, apostrophes and spaces
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
WE CANNOT ACCEPT A PO BOX AS A PHYSICAL ADDRESS. KINDLY ENTER A PHYSICAL ADDRESS FOR YOUR BUSINESS.
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
Please click here to be directed to an application that is specifically for those whose business is in .
Quote only for this state.

Due to the natural disaster in your area, We are unable to provide a policy to purchase for your selected effective date, please go back to this option and select a date that is available to you. We will begin selling same day policies again in your state when the memorandum has been lifted.

This field is required
Invalid physical ZIP code
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
Your state and zip code are invalid. Please edit your address. Suggested state:

Mailing address

This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
Please click here to be directed to an application that is specifically for those whose business is in .
Quote only for this state.

Due to the natural disaster in your area, We are unable to provide a policy to purchase for your selected effective date, please go back to this option and select a date that is available to you. We will begin selling same day policies again in your state when the memorandum has been lifted.

This field is required
Invalid ZIP code
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.

General liability limits

General Liability Aggregate $2,000,000
Products & Completed Operations Aggregate $2,000,000
Personal & Advertising Injury $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit $100,000
Medical Expense Limit $5,000

Locations information

This field is required
This field is required
This field is required
This field is required
×

{[{ documentToSign.title }]}

{[{ value }]}

{[{ formField.stickerCount }]}. Fill In {[{ formField.stickerCount }]}. Sign (Optional) {[{ formField.stickerCount }]}. Check
Signature
{[{ formField.fieldDescription }]}

Policy Holder Edit

, ,
Email:
Email:
Mobile number:

Mailing Address is the Same as the Physical Address
Mailing Address:
, ,

Payment Information Edit

Payment Method:

Nutra Products Annual Insurance Policy (simplified UW)

Payment Breakdown

Policy start date: - Policy end date: Edit

If changes are needed, please reach out to your agent.
Edit

General liability limits

General Liability Aggregate $2,000,000
Products & Completed Operations Aggregate $2,000,000
Personal & Advertising Injury $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit $100,000
Medical Expense Limit $5,000

Policy Holder Business Information

Edit
Business Type
name
DBA
Mobile number
Website
Business Activities
Business Activities Description
Product Description

Manufacturing Questions

Edit
Is your business domiciled in the US?
Please provide more information:
Who manufactures your products?
Do you comply with Good Manufacturing Practices (GMP)?
Are any products, ingredients, or components thereof manufactured out of a residence?
Are your products tested by a third party lab?
Do you do any contract manufacturing?
Percentage of sales?
Do any of your products require a prescription or doctor approval?
Have you ever recalled or are considering recalling any product?
Have any of your products or ingredients or components thereof ever been the subject of any investigation, enforcement action, or notice of violation of any kind by any governmental, quasi-governmental, administrative, regulatory oversight body?
Other than what's listed on this application, do you offer any other products or services?
Do you product or manufacture any CBD products?
Are you a distiller, extractor, processor, or grower of CBD/Hemp?
Is any CBD/hemp imported from outside North America?

Insurance & Claim Questions

Edit
Do you have existing insurance coverage in place?
Previous Carrier Name:
Limits
Expiration Date
Retroactive Date:
Attached file:
Have you had any liability or property claims in the last 5 years?
Are you aware of any fact, incident, circumstance, situation, defect or suspected defect which may result in a claim?
Do you agree that there is no coverage afforded under this policy for the following products, derivatives, or related botanicals and/or extracts, whether as a primary ingredient or in combination with other ingredients
Excluded Products
DO YOU WANT THE POLICY TO BE REVIEWED BY UW?

Additional Insureds

Edit
Unlimited Additional Insureds
Additional Insureds
{[{ ai.name }]}

Employees

Edit
{[{ employee.firstName }]} {[{ employee.lastName }]}

Independent Contractors

Edit
{[{ contractor.firstName }]} {[{ contractor.lastName }]}

Your policy will be issued and your documents available immediately after clicking the "Purchase Policy" button below. Your policy application may be subject to review by our underwriting team to verify that the business operation, product, and/or service meet the eligibility guidelines established for the program. In the event we need further clarification to determine eligibility, we will contact you via email at the email address used to establish your account. If an account is found to be ineligible during the underwriting period, the policy will be subject to immediate cancellation and a full refund will be issued. After the underwriting period, the premium is 100% earned and no refunds will be given.

Your agent will be contacting you soon. There is a pending document to be submitted.

Initial payment:

Switch to annual

Credit card information

This field is required
Invalid credit card number
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field requires 13 to 16 digits. Use only numbers. No spaces or dashes.
Please enter your credit card and bank information. Your credit card will be used for the down payment and your bank information will be used for the Capital Premium finance agreement monthly draft. If you have questions about alternative payment methods for the capital monthly draft please contact Capital Premium.
This field is required
Use the up and down arrow keys to select your card's expiration month. Each option is labeled with the full month name.
This field is required
Use the up and down arrow keys to select your card's expiration year.
This field is required
Invalid cvv
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This is a 3-digit number on the back of Visa, MasterCard, and Discover cards, or a 4-digit number on the front of American Express cards.
This field is required
Invalid ZIP code
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
Enter your 5-digit ZIP code. Only numeric input is accepted.

This feature will create a customer payment profile for your billing information to allow easy checkout during future policy coverage extensions or updates. Credit card information is not stored within our system. All billing information is processed through authorize.net

Calculating price. Please wait...
/month for months
Down Payment(due today):
APR Interest Total

Quote Agreement

Preview my agreement

Credit card information

This field is required
Invalid credit card number
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field requires 13 to 16 digits. Use only numbers. No spaces or dashes.
Please enter your credit card and bank information. Your credit card will be used for the down payment and your bank information will be used for the Capital Premium finance agreement monthly draft. If you have questions about alternative payment methods for the capital monthly draft please contact Capital Premium.
This field is required
Use the up and down arrow keys to select your card's expiration month. Each option is labeled with the full month name.
This field is required
Use the up and down arrow keys to select your card's expiration year.
This field is required
Invalid cvv
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This is a 3-digit number on the back of Visa, MasterCard, and Discover cards, or a 4-digit number on the front of American Express cards.
This field is required
Invalid ZIP code
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
Enter your 5-digit ZIP code. Only numeric input is accepted.

This feature will create a customer payment profile for your billing information to allow easy checkout during future policy coverage extensions or updates. Credit card information is not stored within our system. All billing information is processed through authorize.net

This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
This field is required
You must own the business to purchase the insurance policy. We identify that this business name is disallowed from purchase.
Loading...

Your form contains error(s). Please correct and try again.

An account with this email address already exists. Please login or change email address.
You need a policy that's as unique as your business. After your quote is submitted, one of our sales agents will contact you within 48 hours to complete your quote.

We noted you have made changes to the application you previously submitted. After clicking SUBMIT FOR QUOTE, your application will be sent again for our team to review.

Please click here to be directed to an application that is specifically for those whose business is in .
Quote only for this state.
Nutra Products Annual Insurance Policy (simplified UW)

Policy Endorsements

Additional insureds

Coverage for Employees

Coverage for Independent Contractors

Loading... $
This will be your recurring monthly payment after today. We will automatically charge your card each month.
$
monthly
DUE TODAY: (downpayment)

Sign Here