Request a Quote Need an insurance quote? Contact Specialty Agriculture Insurance Company of Michigan. "*" indicates required fields Your Role*RetailerBroker of Insurance ProductsLicenseeName* First Last Email* When do you need to bind coverage?*Within the weekImmediatelyWhat is the licensee's name?* First Last Business Name What is the facility address?* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Already licensed?*NoYesNumber of Medical*Number of Adult-Use**If you have more than 10 licenses, please contact us at 616-560-2398 directly!Add Medical LicensesMedical License Number Add RemoveAdd Adult-Use LicensesAdult-Use License Number Add RemoveType of license(s) being applied for?*Not sureMedicalAdult-UseBothPlease select types of Medical License being applied for:* Grower Class A Grower Class B Grower Class C Grower Class Excess Retailer / Provisioning Processor Marijuana Safety Compliance Facility Marijuana Secure Transporter Please select types of Adult-Use Licenses being applied for:* Marijuana Microbusiness Marijuana Consumption Lounge Temporary Event Please select types of license being applied for:* Grower Class A Grower Class B Grower Class C Grower Class Excess Retailer / Provisioning Processor Marijuana Safety Compliance Facility Marijuana Secure Transporter Marijuana Microbusiness Marijuana Consumption Lounge Temporary Event PhoneThis field is for validation purposes and should be left unchanged.
