Cyber Liability Application

Please answer the questions below to confirm your eligibility for our program and obtain a real-time quote.

                            Business Name
                            
                        

                            Address
                            
                        

                            City
                            
                        
StateAK
				AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY

			

                            Zip
                            
                        

                            Email Address
                            
                        

                            Phone Number
                            
                        

To the right is a list of ineligible classes of business. Does your operation fall into any of these classes?

                                    Does the majority of your revenue come from selling motor vehicles?
                                
Please enter your gross sales revenue below.  The premium will be based on 15% of this amount.

Ineligible Classes

                                    Banks
Credit Unions
Payment Processors
Gambling Organizations
Online Adult Industry
Social Media/Networking Firms

                                

                                    Cloud Providers
Network Providers
Managed Security Providers
Managed Service Providers
Federal and State Government Agencies 

                                

                                    Municipalities
Franchise
Cryptocurrency
Marijuana/Cannabis
Schools and Universities (Public, Private and Charter)

                                

                            Annual Revenue ($)
                            
                            Do you have offsite (e.g. cloud) back-ups which are less than 1 month old?
                        
                            Are you able to recover critical data & systems within 3 days?
                        
                            Do you implement Multi-Factor Authentication (MFA) for remote access to your network?

                                    Have you suffered a cyber-related event, breach, outage, loss, or claim in the past 12 months?
                                
                                    For all fund transfer requests or payments, do you confirm payment instructions via a method other than the original means of the instruction (for example, calling an individual at an independently verified number to confirm an email wire transfer request)?