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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 Special Events EZ-Quote 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 of Your Company / Organization:
  
Entity Type ( Indiv, Corp. LLC, etc.):
Physical Street Address (No P.O. Box):
City:
State, Zip Code:
Mailing Address (P.O. Box - okay):
Contact Person:
Phone:
Fax:
E-mail Address:
  
Website Address:
How much experience do you have at operating this type of event?
    QUALIFICATIONS QUESTIONS
Any: Stunts, Pyrotechnics, Aircraft, Hazardous Activities, Car Races,
Precision Driving, Mechanical Devices, Film Production, Rap/Hip-Hop, Rock/Metal,
Rides, Water Activities:
Please describe:
The event will take place in the United States:
Any armed private security guards?
Any Prior event with any losses of any kind?
Any bounce houses or inflatables (If yes, certificates of insurance are required)
Will your event occur in a bar or nightclub?
    EVENT DETAILS
 
  COVERAGE DATES OF THE EVENT  
  EFFECTIVE:  
  EXPIRATION:  
  Time of Event:  (If event is past midnight - add extra day - as insurance expires at 12:01am)  
  Load In / Load Out Dates:
Do you want these rates included in your quote? 		 
   
  ATTENDANCE  
Important for rating purposes -->
Average Daily Spectators/Guests:
 

Important for rating purposes -->
Average Daily Participants: (volunteers, ushers, ticket takers, athletes, performers, etc.)
Please describe participants and how many of each: 
 
   
Type of Event:
Event Name:
Budget (Cost of Event):
Brief Description of Event:
Event Website:
Venue Name:  
    Physical Street Address (No P.O. Box)
    City, State, Zip:
Location Information:
  PLEASE ATTACH A COPY OF THE VENUE CONTRACT OR SAMPLE VENUE CONTRACT ON STEP TWO OF THIS APPLICATION
Any Celebrities at Event? None
List Celebrities (if any) at Event:
   FOR CONCERTS ONLY 
Type of Music:
Music Decade:
Artist Name:
   ADDITIONAL INSUREDS 
Do you hire any subcontractors for the insured event(s), (ie: caterers, bands/entertainment, lighting, sound, staging, decorations, security, etc.)?
   If Yes, Please describe:
Do you require all subcontractors to have their own insurance and provide you with a Certificate of Insurance (COI) naming you as an Additional Insured (AI)?
 
How many security personnel will be present? (If none, enter: 0) 
  For higher risk events it may be required to have 1 security person per 100 attendees.
Do you hire security?
Name of Security Company: 
Number of Types (If none, enter: 0):  
On Duty Police Officers:
Off-Duty Police Officers:
Private Armed Security:
Uniformed (unarmed) Security:
T-shirt Security:
Other:  
If you hire private security a Certificate of Insurance (COI) naming you as an
Additional Insured (AI) will be required.
Do you have metal detectors at all entrances and exits that
attendees and performers must pass through? 		 
  This will be required for higher risk events.
 
   COVERAGE OPTIONS 
GENERAL LIABILITY  
  Blanket Additional Insureds & Certificates, including City Certs:     Automatically Included  
   
Occurrence / Aggregate Limit:




 
  Waiver of Subrogation (only if required by contract):    Include   Exclude
 
  If "Include" is selected:
   1. What is the name of the entity requesting the waiver of subrogation?  
   2. What is their involvement in the event?  
 
ADDITIONAL COVERAGES
  Rented Equipment Limit ($5,000 minimum - $2,000,000 maximum):   $
 
  1. What type of property do you need coverage for? 
  2. Will the property be stored overnight? 
       If Yes, please provide details on how it will be stored:
  3. Will the insured be responsible for transporting the property?
 
 
If "Yes", Please describe how it is being transported: 
If "No": Who is transporting the property?
1. Who is transporting the property? 
 
Insured:        Rental House        Other:
2. Is the company transporting the property naming the Insured as Additional Insured on their insurance policy?
  4. Will the property stay in the possession of the Insured at all times prior to returning to rental company? 
    IF “NO”, please explain: 
 
 
 
Third Party Property Damage (Minimum premium $100):
    (Important Coverage for the Venue)






   
 
Liquor Liability ($1,000,000 Limit)         Include   Exclude
  If included, Will alcohol be served by a Licensed bartender?
If No, Who will be serving the alcohol? (If none, enter: 0)
Describe the training and/or experience of persons
serving alcohol:
Average age of attendees: (If none, enter: 0)
What measures are in place to prevent the service
of alcohol to minors and/or intoxicated persons?
(Wrist bands, stamped wrist, tickets with I.D. check, none, etc.)
Does the Applicant have a valid Liquor License?
If No, who has the liquor license?
(Please identify by name and if a
caterer, restaurant, sponsor,
event planner, none, etc.)
Please describe what kind of alcohol will be served: Beer     Wine     Cocktails    Other:
Will there be an open bar?
Will alcohol be sold by the drink?
Is BYOB (bring your own bottle) allowed?
Estimated alcohol gross receipts? (If none, enter: 0)
 
  Hired & Non-Owned Auto Liability ($1,000,000) (Minimum premium $500)    Include   Exclude
 
Check here if you are required by contract to acquire Hired/Non-Owned Auto and you NOT being loaned, rented or leased any vehicles. If checked, please provide a copy of the contract.
   If not, please complete the questions below:
       1. Amount being charged to rent or lease the vehicle(s)?     
  2. Are all drivers at least 25 years of age? 
  3. Do all drivers have a valid United States drivers license?
  4. Do any of the hired vehicles seat more than 12 people?
   
  What will the vehicles be used for? 
Event Cancellation, Participants Medical, Spectators Medical
Event Cancellation (Minimum premium $250): Include   Exclude
Participants Medical (Minimum premium $200): Include   Exclude
Spectators Medical (Minimum premium $200): Include   Exclude
 
VENDORS COVERAGE
(Only if you want your coverage extended to the vendors)
 
Number of Exhibitors (no sales):
  Concessionaires (non-food sales):
  Concessionaires (food sales):
  Performers and Attractions:
  Do you require all Vendors/Exhibitors to have
their own liability insurance and provide you with
a certificate of insurance naming you as an additional insured?
 
   
WORKERS COMPENSATION     Include   Exclude  
     Waiver of Subrogation (only if required by contract)    Include   Exclude
  If needed, please include contract with application
 
    If "Include" is Selected:
 
    1. What is the name of the entity requesting the waiver of subrogation? 
  2. What is their involvement in the event?
  Payroll Company Name (if any):
 
Payroll Classification # Full-Time # Part-Time (W-2, 1099, Deferred, Other (Please identify)
Performers
Crew/Volunteers
Others (Describe)
 
Listing of All Officers (to exclude from workers comp):
First Name Last Name Title/Position
 
   
ADDITIONAL COMMENTS:  
   
 
FOR AGENT USE ONLY
Insurance Agency Name:
Office Street Address:
City:
State, Zip Code:
Agent Contact Person:
Agent Contact Person Email:
Agent Contact Phone Number:
Agent Fax 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)