Insurance Program Administered by Lockton Affinity, LLC

Professional Liability Application

For your convenience, professional liability applications are available on-line in PDF format.

To print, complete and fax/mail an application to RESNET Insurance Program:

1. CLICK HERE to open the PDF file
2. Print the application
3. Complete the application and:
   a. Fax to 913-652-7599 OR
   b. Mail to:

   RESNET Insurance Program
   P.O. Box 410679
   Kansas City, MO 64141-0679
   

To download a free copy of Adobe Reader, click the link below