Liquor Liability Application | Conifer Insurance

Effective March 20th, 2019, Conifer has suspended cancellation of policies due to non-payment of premium for clients who indicate financial impact by the recent COVID-19 outbreak and are experiencing trouble making a payment. Additionally, late pay fees have been waived at this time.


Liquor Liability Application | Monoline

Please answer all questions completely. Completion of this application does not constitute coverage.

[ACTIVE] Liquor Liability - Quick Quote

General Information


Applicant Information

Business Address *
Business Address

Underwriting Information

Entertainment on Premises? *
Which Days per Week
Requested Liquor Liability Limit(s) *
Is the applicant a member of the Midwest Independent Retailers Association (MIRA)?
Members may be eligible for premium discounts

Additional Information (Not Required)

Optional Attachments

Maximum file size: 8.39MB

Example: Current policy, loss runs or underwriting information