Insurance for Certified Personal Trainers

API Fitness

Insurance for Certified Personal Trainers

Fitness Studio, Gym and Health Club Owners Insurance | Home

WORKERS COMPENSATION APPLICATION

1. Business Information

Effective Date:

Business Name (Legal):

DBA:

Insured’s Name:

Date of Birth:

Type of Business Entity: CorporationLLCPartnershipIndividual/Sole ProprietorOther:

How did you hear about us?

Business Address:

City:

State:

Zip:

Mailing Address:

City:

State:

Zip:

Website:

Phone:*

Email:*

Expected Annual Sales:*

Year Business Started:

FED Tax ID:

2. Employee Information

Total Employee Annual Payroll:*

Number of Employees:

FT:

PT:

Business Description:

Are all Business Officers being included in Coverage? YesNo

Total Expected Salary of Officers Included in Coverage:

How Many Officers/Owners? Sole OwnedMulti Owned: #

List All Excluded Officers (Name, Date of Birth, Title, % Ownership, Duties):

3. Current Insurance

How long has the business had active Workers Comp Insurance?

Current Policy Expiration Date:

Current Insurance Company:

Current Premium:

Prior Claims: YesNo If Yes, Please Provide the Date and Details Below:

4. Additional Insurance

If You need to add an Additional Insured, please list below:

Name of Additional Insured:

Relationship to Additional Insured:

Street Address:

City:

State:

Zip:

AI Requirement: Please Mark If Required by Additional Insured:

Waiver of Subrogation

Do You Have 50% Interest in Another Business?:

YesNo

If Yes, Please Specify:

Additional Insurance:

Would You Like a Quote For: (Please mark)

Commercial General Liability InsuranceUmbrella/Excess Liability InsuranceBusiness Owners Policy InsuranceDirectors & Officers Insurance (D&O)Employees Practices Liability Insurance (EPLI)Commercial Auto InsuranceCyber Liability Insurance

Affiliates and Partners

API Fitness
Allied Professionals’ Insurance Services, Inc.
1100 W. Town & Country Rd, Suite 1400
Orange, CA 92868

Tel: (800) 860-8330
Fax: (714) 571-1863

Hours:
8am – 5pm PST / 11am – 8pm EST
Monday thru Friday

Submit Applications:
submissions@apifitness.com

Questions and Support:
Doug Jester
Direct: (714) 647-6495
djester@apisinsurance.com

Additional Forms

Download

CA License #: 0789618 | Licenses in all 50 U.S. States and Territories

MEMBER
RENEWAL APPLICATION

Our Renewal Portal is under development. Please contact customer service to renew your policy. Thank you.