Refund Policy
Coverage purchased via this website is fully refundable if the following conditions are met:

The insured event did not occur, and notification was given to us prior to the effective date of coverage. Please be advised that coverage begins at 12:01 a.m. on said effective date.

We will not cancel coverage or refund any premium once the coverage becomes effective.

TO CANCEL AN EVENT INSURANCE POLICY PLEASE CALL MERRIWETHER & WILLIAMS INSURANCE SERVICES INC. AT (800) 420-0555 / (415) 986-3999

Merriwether & Williams Insurance Services, Inc. reserve the right to modify this Refund Policy at their discretion. Any such revision or change will be binding and effective immediately after posting of the revised Refund Policy on Sparta Insurance Programs website. You agree to periodically review our website, including the current version of our Refund Policy. Our refund policy is made available on our website. It is your obligation to review our refund policy for any such revisions.

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SPARTA APPLICATION

APPLICANT INFORMATION

Applicant's (Company) Name: *

Contact Person: *

Phone: *
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Fax:
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Address: *

City: *

State: *

Zip Code: *

Email: *


POLICY INFORMATION

Certificate of Liability Insurance required by:
PUBLIC ENTITY: *

Department:

DESCRIPTIONS OF OPERATIONS: *

COVERAGE TYPE: *
Check all that apply
General Liability
Professional Liability
Non-Owned Autos

Starting Date: *

PROPOSED CONTRACT PERIOD: *
3 Months
6 Months
1 Year
Other

CONTRACT VALUE: *
(Amount of money you will RECEIVE)

I am an authorized representative of the applicant and certifies that reasonable enquiry has been made to obtain the answers to questions during the application process. I further understands that any coverage provided is limited to the work performed as outlined, and for the Department identified, in the Terms & Conditions section of this quote. I certify that the answers are true, correct and complete to the best of his/her knowledge.

Please print a copy of this application for your records.







California License # 0C01378
Refund Policy