Changes In Your Operations?

Please Complete The Form Below

Phone

This field is for validation purposes and should be left unchanged.

Organization name(Required)

Your name

First Last

Email(Required)

Phone

Changes in Operations

Please indicate what changes or additions have been made to your operations(Required)

For example: new funding source, new location, deleting a location, new vehicle, special event, new service. Please describe the details.

Additional Insured

Are you adding a new additional insured?

Yes

Name and address of the additional insured

Please also attach the contract or agreement in the Documents section below.

Locations

Are you adding or deleting a location?

Adding a location

Deleting a location

No change

Address of the new location

Please also attach a copy of the lease in the Documents section below.

Approximate square footage

Which location are you deleting?

Special Event

Are you adding a new special event?

Yes

Date of event

Time of event

Location of event

Describe the event

For example: dinner, silent auction, fundraiser.

Number of attendees

Will alcohol be sold or served?

No alcohol

Served only

Sold only

Both sold and served

Vehicle

Are you adding a new vehicle?

Yes

Year, make and model

Cost of vehicle

VIN #

Documents

Please attach any agreements, contracts, leases, etc.

You can attach more than one file.

Drop files here or

Max. file size: 64 MB.

Need a Person?

14752 Beach Blvd Suite 143, La Mirada CA 90638
Mailing address: P O Box 736, La Mirada CA 90637
lillian@bakerromero.com
(626) 332-2258
Monday – Friday 9:00am – 5:00pm