Foreign Legal Liability Application Complete the form. Click Submit and the completed form will be emailed to Bonnie Ridolfino at Hardenbergh Insurance Group If you have any questions, please feel free to contact Bonnie at bonnie@hig.net General InformationDistrict Name:*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact Name* First Last Email* Phone*Quote Needed By* Date Format: MM slash DD slash YYYY Description of Foreign Trips planned within a 12-month period (# of days and all countries visited)*Number of Employees*Number of Students*Number of Volunteers*Separate Applications Required for*Kidnap & ExtortionPropertyDefense Base ActNone of the AboveTrip Travel Exposure for Students/ChaperonesWhat activities are performed by your students/chaperones while outside the United States?*Conferences, conventions, seminars, on-site inspections, field engineering studies, cultural/sightseeing tripsPhysical/manual LaborApplicant Full Name (This acts as your signature)* First Last Today's Date* Date Format: MM slash DD slash YYYY