AMBASecure (Step 1 of 3)
Complete the following in order to proceed to the electronic Payment options.
Policyholder Status:
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New Customer
Existing Customer
First Name:
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Last Name:
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Business Name:
Email Address:
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Policy Number:
Account Number:
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Account Number:
One Time Authorized Payment Amount ($):
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For all credit/debit card transactions, the total amount to be charged will be the authorized policy payment amount plus a processing fee charged by the third-party payment processor, One Inc. One Inc charges a 2.99% payment service fee. For CT customers only, the amount owed by the customer includes One Inc charges, but payments made via ACH or check will be discounted by 2.99%
Please check this box if you are not uploading any document(s):
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Upload Document:
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List of Uploaded Documents:
Note:
1. Maximum 10 documents can be uploaded and maximum size of 30 MB for all documents.
2. If no documents are added the checkbox above is required to be selected.
User Comments:
Submission of your payment does not constitute approval or binding of coverage by the insurer. Coverage is subject to the terms and conditions of the insurance policy issued by the insurer.