30 Years Experience
   
ENTERTAINMENT PRO INSURANCE
   Motion Picture, Television, Theatrical, Music, Broadcasting and Special Events   
   
Login
  Site Map  |  Contact
       
Skip Navigation LinksHOME > APPLICATIONS > ONLINE FORMS > EQUIPMENT FLOATER
Step One: Complete Form
Step Two: Review and Submit
Step Three: Finish
Welcome to Equipment Floater Application from Entertainment Pro Insurance.

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.
 
  CONTACT INFORMATION
Name Insured:
 
Entity Type:  
Country of Residency (If Individual):
Country of Residency (All others):
Primary Address (No PO Box):
                City:
    State:
    Zip:
                    Mailing Address (If different to primary):
                City:
    State:
    Zip:
Contact Person:
Phone / Fax:
E-mail Address:
 
Website:
Year Business Established:
Description of Operations:
    QUALIFICATIONS QUESTIONS
Is the applicant in the business of renting equipment to others?:
    INSURANCE HISTORY
LOSSES    
 
Any losses in the past 3 years? (If yes, provide details) :
Policy Type  / Line of Business Date of Loss Description Amount of Loss
PRIOR COVERAGE
 
Any prior insurance? (If yes, provide details) :
Policy Type Carrier Policy # Expiration Date Premium
CANCELLED or DECLINED INSURANCE (not applicable in MO)
 
Any insurance declined or cancelled in the past 3 years?
  If yes, provide details:
   SECURITY
        Years Industry Experience:
  Alarm Type (check all that apply):
Smoke Fire Burglar  
  Alarm Monitoring Company:
   COVERAGES
  Dates of Coverage/ Effective:  (12 month coverage term)
       
 
Coverage   Limit Deductible
Inland Marine (* Indicates required coverages if Inland Marine is purchased)
  Owned Equipment *    
     Editing/Post Production Equipment   
     Recording/Studio Equipment   
     Sound/Location Recording Equipment   
     Musical Instruments/Band Equipment   
     Camera/Production Equipment   
     P.A./Sound Equipment   
     Theatrical Equipment   
     Props, Sets, Wardrobe   
  Rented Equipment       
     Camera, lighting, sound, etc.   
     Props, Sets, Wardrobe   
     Furs, Jewelry, Arts, Antiques  
       
  Negative Film, Videotape, Digitalized Image   
  Faulty Stock, camera & Processing    Same as Negative Film
  Library Stock Coverage   
  Extra Expense  
  Third Party Property Damage   
  Office Contents  
  Business Income/Extra Expense   
  Rental Cost Reimbursement   
  EDP   
  Limited Computer Virus Coverage   
  Accounts Receivable   
  Valuable Papers   
   Money & Securities  
  Worldwide Coverage Territory    Include   Exclude
  Waiver of Subrogation   Include   Exclude
  Coverage Extension Endorsement*     Include   Exclude 500
  * (Valuable Papers 2500, Signs 10000, Outdoor Property 5000 Per Item 25000 total, Electronic Media And Records 5000, Debris Removal 50000, Employee Dishonesty 5000, Fire Department Service Charges 25000, Fire Equipment Recharge 10000, Polutant Clean Up And Removal 15000, Sewer Backup 25000, Temporary Location 25000, Accounts Receivable 25000, Money & Securities 5000)
   
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)