All Information and Documents below are Required!

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Company name

First name (during event)

Last name (during event)

Phone (during event)

Emergency Contact Name

Emergency Contact Phone

Proof of Insurance

Please upload your certificates of insurance below. They can be uploaded in eitherpdf or photo form. Certificates must show proof of A $1MM combined single limitof liability for bodily injury/property damage claims, personal/advertising liability,and products/completed operations. Policy general aggregate of at least $1MM andfire legal damage with a limit of at least $100,000. Coverage must includecontractual liability. Certificates must also list the following additional insureds:

Aponi Productions, P.O. Box 534, Broomfield, CO 80038 and

Old Colorado City Associates, P.O. Box 6206, Colorado Springs, CO 80934

If you need to purchase insurance, you can do so at the link below:

securevendorinsurance.com/deanje

USE THE 3 BUTTONS BELOW TO ATTACH YOUR INSURANCE COI'S

COI upload

Please provide your State of Colorado single or multiple event sales tax license #

Please provide your City of Colorado Springs sales sax license #

I accept the terms and conditions. Terms of Service

Signature

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