All Information and Documents below are Required! READ CAREFULLY

Company name

First name (during event)

Last name (during event)

Phone

Emergency Contact Name

Emergency Contact Phone

Proof of Insurance

If you need to purchase vendor insurance, you can do so by clicking here: Vendor 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:

Two Mile High Club, P.O. Box 306, Cripple Creek, CO 80813 and

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

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

File upload

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

Please provide your Teller County Health Department Special Event license #

I accept the terms and conditions. Terms of Service

Signature

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