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 DICE/Annual Productions (Adult Entertainment) Application Instructions

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Applicant Information

< select > Corporation Individual Joint Venture Limited Liability Corporation Limited Liability Partnership Non-Profit Partnership Trust

Email:

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Will any production include stunts, pyrotechnics, aircraft, boats, animals, race tracks, race courses, helicopters, motorbikes, snowmobiles, ATVs, blanks, squibs, guns, or other hazardous activities?

Client Information

Additional Operations

If Yes, provide web address.

If Yes, provide insurance coverage details.

Any Insurance Declined or Cancelled in the Past 3 Years?

< select > No Yes

Any prior production with any losses of any kind?

Any Prior Insurance Coverage?

< select > No Yes

Risk Classification

Post Production Revenue:

Number of Employees:

Effective Date:

Annual Policy Period

Inland Marine

Property & Equipment Coverages

Rented Furs, Jewelry, Art & Antiques Coverage:

Excluded 5,000 10,000 15,000 25,000 35,000 50,000 75,000 100,000

The Props, Sets & Wardrobe form provides up to $25,000 for furs, jewelry, arts, antique coverage. If a higher limit is required, include the additional limit under this coverage. A schedule/appraisal of the item(s) will be required.

Faulty Stock Broad Form:

Excluded Included

Broadens the faulty stock coverage by providing coverage for: faulty manipulating or judgment of the camera operator or assistants; error(s) of judgment in exposure, lighting or sound recording; use of incorrect raw film stock or videotape or media/software; and errors in machine programming or instructions to the machine.

Library Stock Coverage:

Excluded 10,000 25,000 50,000 75,000 100,000

Expands the definition of negative film, videotape and digitalized image to include insured's original cut negative film of completed or released productions, duplicate negatives, completed video tapes or other related media.

Rental Cost Reimbursement:

Excluded 5,000 10,000 25,000 50,000 75,000 100,000 125,000 150,000

Limit Per Day

Covers the potential additional expense to rent similar equipment after a loss.

EDP:

Excluded 25,000 w/ 500 Deductible 25,000 w/ 1,000 Deductible 25,000 w/ 1,500 Deductible 50,000 w/ 500 Deductible 50,000 w/ 1,000 Deductible 50,000 w/ 1,500 Deductible 75,000 w/ 1,500 Deductible 100,000 w/ 1,500 Deductible 150,000 w/ 1,500 Deductible 200,000 w/ 1,500 Deductible 250,000 w/ 1,500 Deductible 250,000 w/ 2,500 Deductible 300,000 w/ 1,500 Deductible 300,000 w/ 2,500 Deductible 350,000 w/ 1,500 Deductible 350,000 w/ 2,500 Deductible 400,000 w/ 2,500 Deductible 400,000 w/ 3,500 Deductible 450,000 w/ 2,500 Deductible 450,000 w/ 3,500 Deductible 500,000 w/ 2,500 Deductible 500,000 w/ 3,500 Deductible 500,000 w/ 5,000 Deductible 550,000 w/ 5,000 Deductible 600,000 w/ 2,500 Deductible 600,000 w/ 3,500 Deductible 600,000 w/ 5,000 Deductible 750,000 w/ 2,500 Deductible 750,000 w/ 3,500 Deductible 750,000 w/ 5,000 Deductible 700,000 w/ 5,000 Deductible 1,000,000 w/ 3,500 Deductible 1,000,000 w/ 5,000 Deductible 1,000,000 w/ 7,500 Deductible

Electronic Data Processing Equipment

Computers and related equipment, media, software. Software extra expense is automatically included up to 25% of the hardware limit.

Limited Computer Virus:

Excluded 10,000 25,000

Attaches to EDP and provides limited coverage for computer viruses.

Excluded 10,000 25,000 50,000 100,000

Extra expense due to the interruption, postponement or cancellation of an “insured production” that is directly caused by or results from the operation of civil authority. The operation of civil authority must prohibit access due to threat of or actual loss or damage to property allowing access to or use of facilities you occupy or intend to occupy in connection with an “insured production” during the term of coverage.

Excluded 10,000 25,000 50,000 100,000

Provides coverage for contractually obligated (yet unanticipated) talent, services or facilities costs incurred to reshoot the production after a covered loss.

Excluded 10,000 25,000 50,000 100,000

As a result of an officially sanctioned strike or civil protest, covers the loss due to the interruption, postponement or cancellation of the production.

Waiver of Subrogation:

Coverage Extension Endorsement:

Cinema Production Enhancement Endorsement:

Worldwide Coverage:

Excluded 100% of Budget w/ $10K Ded 100% of Budget w/ $25K Ded 100% of Budget w/ $50K Ded 100% of Budget w/ $100K Ded 75% of Budget w/ $10K Ded 75% of Budget w/ $25K Ded 75% of Budget w/ $50K Ded 75% of Budget w/ $100K Ded 50% of Budget w/ $10K Ded 50% of Budget w/ $25K Ded 50% of Budget w/ $50K Ded 50% of Budget w/ $100K Ded 25% of Budget w/ $10K Ded 25% of Budget w/ $25K Ded 25% of Budget w/ $50K Ded 25% of Budget w/ $100K Ded

Provides extra expense incurred in the completion of a production over and above the normal budgeted costs due to the death or disability (accident or sickness) or kidnapping of any scheduled artist. Cast coverage provides protection from pre-production through production and post-production. All artists must be scheduled in advance and medicals are required for sickness coverage. For coverage on an unscheduled basis, you may also include the 'covered person extension with sickness coverage'.

Excluded Included

Provides accidental injury or accidental death cast coverage without having to schedule artists. If sickness coverage is required for any artists, those artists must be scheduled (a reduced limit for sickness coverage on an unscheduled basis is available under the 'Covered Person Extension with Sickness' coverage). Expands the definition of covered person to include any person necessary for the completion of the insured production.

Excluded 5,000 per person / 25,000 Aggregate 10,000 per person / 50,000 Aggregate 25,000 per person / 100,000 Aggregate

Provides accidental injury, death and sickness coverage without having to schedule artists. Expands the definition of covered person to include any person necessary for the completion of the insured production.

Excluded Included

Expands cast coverage to provide for a bereavement period up to 5 days due to the death of an immediate family member.

Unscheduled Owned Equipment:

Excluded 10,000 25,000 35,000 50,000 75,000 100,000 125,000 150,000 175,000 200,000 225,000 250,000

100,000 300,000 500,000

City/Other Special Certificates:

Excluded Included

FilmL.A., Inc., NYC Mayor's Office of Film, Cities that require Special Wording on Certificates, etc.

Waiver of Subrogation:

Excluded Included

Primary & Non-Contributory Wording Occasionally Required by Locations

Employee Benefits Liability:

Excluded 125,000/500,000 w/ 10%, 1,500 min deductible 125,000/500,000 w/ 10%, 2,500 min deductible 250,000/500,000 w/ 10%, 1,500 min deductible 250,000/500,000 w/ 10%, 2,500 min deductible 125,000/1,000,000 w/ 10%, 1,500 min deductible 125,000/1,000,000 w/ 10%, 2,500 min deductible 250,000/1,000,000 w/ 10%, 1,500 min deductible 250,000/1,000,000 w/ 10%, 2,500 min deductible 125,000/2,000,000 w/ 10%, 1,500 min deductible 125,000/2,000,000 w/ 10%, 2,500 min deductible 250,000/2,000,000 w/ 10%, 1,500 min deductible 250,000/2,000,000 w/ 10%, 2,500 min deductible

Per Vehicle / Aggregate

Excluded Included

Primary & Non-Contributory Wording

Hired & Non-Owned Auto Liability is rated based upon the cost to rent vehicles, duration of rentals and the number of vehicles that will be rented.

# of Days

# of Vehicles

Mobile Studios and Film Trucks

Other Than Mobile Studios and Film Trucks

Occurrence / Aggregate Limit:

Excluded 1 million / 1 million 2 million / 2 million 3 million / 3 million 4 million / 4 million 5 million / 5 million 6 million / 6 million 7 million / 7 million 8 million / 8 million 9 million / 9 million 10 million / 10 million

The excess liability is an additional layer of coverage above the general liability, auto, and employers liability. Note that this excess policy will only sit on top of risks insured through Abacus programs.

Guild Members, Non-Guild Members, Aggregate Limit:

Excluded 1mil Guild, 50k Non-Guild, 5mil Agg 1mil Guild, 50k Non-Guild, 10mil Agg 1mil Guild, 100k Non-Guild, 5mil Agg 1mil Guild, 100k Non-Guild, 10mil Agg 1mil Guild, 250k Non-Guild, 5mil Agg 1mil Guild, 250k Non-Guild, 10mil Agg 1mil Guild, 500k Non-Guild, 5mil Agg 1mil Guild, 500k Non-Guild, 10mil Agg

Guild refers to employees who are part of a Guild, Trade Association or Labor Union.  The required Guild limit is $1,000,000. Non-Guild refers to all other employees.

Notes