30 Years Experience
   
ENTERTAINMENT PRO INSURANCE
   Motion Picture, Television, Theatrical, Music, Broadcasting and Special Events   
   
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Step One: Complete Form
Step Two: Review and Submit
Step Three: Finish
Welcome to Basic Information for Quotation from Entertainment Pro Insurance.

Read First:
If this is a Special Event and/or Short-Term Film Production - Do not use this form - refer to and choose the appropriate online application.

For fast service on your commercial accounts complete the form below and hit the “Step Two” button. Your submission will be electronically delivered to the next available Commercial Lines Underwriter.
  GENERAL INFORMATION
DBA/Name of Business:
Entity Type:





Name(s) of owners:
% of ownership of each:
Year business started:
Mailing address:
                City:
    State:
    Zip:
Primary location address:
                City:
    State:
    Zip:
Contact Person:
Phone:
Fax:
Email:
Website:
Describe type of business:
Describe your business operations:
   LIABILITY INSURANCE
Prior insurance co.:
Effective Date:
Liability Limit:
Estimated annual sales/revenue:
Estimated annual payroll:
Estimated subcontractor costs:
Are there any additional insureds? (landlord, etc):

Name of Additional Insured:
Address:
                City:
    State:
    Zip:
  PROPERTY INSURANCE - additional locations send in an email
Prior Insurance Co.:
Effective Date:
Location Address:
                City:
    State:
    Zip:
Owner or Tenant?:
Year Built:
Square Footage:
What % of building is occupied by your business:
Construction Type:
Number of Stories:
Sprinklered:


Alarmed:


Name of Alarm Co.:
Bldg Improvements Made?:


Wiring:
Roofing:
Plumbing:
Heating/Air:
Completed what year:
Describe other business types in the building:
Need Building Insurance?:


Building Limit:
Business Personal Property Limit:
Computers/Media Limit:
Mobile Equipment Limit:
   WORKERS COMP INSURANCE
Prior Insurance Co.:
Effective Date:
Number of employees:
Estimated annual payroll:
Estimated annual sub-contractor cost:
   CLAIMS
Any claims in the past 5 years?:


If so, please describe:
   
ADDITIONAL COMMENTS:  
   
 
FOR AGENT USE ONLY
Insurance Agency Name:
Agent Contact Person:
Agent Contact Person Email:
Agent Contact Phone Number:
 
 
FRAUD STATEMENT

Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and (NY: substantial) civil penalties. (Not applicable in CO, HI, NE, OH, OK, OR, VT). In DC, LA, ME, TN and VA, insurance benefits may also be denied.
 
    (You will get a summary page to review before submitting)