Short Term Production (Adult Entertainment) Application Instructions

( indicates required information)

Applicant Information

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

Email:

We will never rent, sell, or share your email address.

< select > No Yes

< select > No Yes

< select > No Yes

Confirm your understanding that if coverage is provided, only one production

will be covered by the policy(s) issued.

I Agree  I Disagree

Any insurance declined or cancelled in the past 3 years?

Any loss in the past 3 years?

Any prior insurance coverage?

Production Details

Maximum eligible budget is 1,000,000.

For budgets over $1,000,000, please apply in Production Portfolio program.

Production Dates:

to

to

to

If insuring rented equipment start with pick-up and end with drop-off day.

Synopsis:

Input a brief description of the shoot and storyline.

Filming Locations

Please choose the territories in which production activities will take place.

< select the country > United States of America Canada < select the state > Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Island Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory

Additional Questions

Will the production include any Stunts, Pyrotechnics, Aircraft, Boats, Animals, Race Tracks, Race Courses, Helicopters, Motorbikes, Snowmobiles, Blanks, Squibs, Guns?

< select > No Yes

Music Video Details

Only if shoot is a Music Video.

Key Production Contact

Foreign entities and/or foreign individuals shooting in the U.S. must have a permanent location in the U.S. or hire the services of a U.S. based producer or executive producer.

< select > Executive Producer Producer

At least 1 producer or executive producer must be scheduled on the production.

Drivers License:

< select > Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

State & Number

Inland Marine

Equipment & Property Coverage

Excluded 10,000 w/ 1,500 Deductible 25,000 w/ 1,500 Deductible 35,000 w/ 1,500 Deductible 50,000 w/ 1,500 Deductible 75,000 w/ 1,500 Deductible 100,000 w/ 1,500 Deductible 125,000 w/ 2,500 Deductible 150,000 w/ 2,500 Deductible 175,000 w/ 2,500 Deductible 200,000 w/ 2,500 Deductible 225,000 w/ 2,500 Deductible 250,000 w/ 2,500 Deductible

Excluded 100,000 w/ 1,500 Deductible 150,000 w/ 1,500 Deductible 250,000 w/ 2,000 Deductible 250,000 w/ 2,500 Deductible 300,000 w/ 2,500 Deductible 350,000 w/ 2,500 Deductible 350,000 w/ 3,000 Deductible 400,000 w/ 2,500 Deductible 400,000 w/ 3,000 Deductible 450,000 w/ 2,500 Deductible 450,000 w/ 3,000 Deductible 500,000 w/ 2,500 Deductible 500,000 w/ 3,000 Deductible 500,000 w/ 5,000 Deductible 600,000 w/ 2,500 Deductible 600,000 w/ 3,000 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 1,000,000 w/ 2,500 Deductible 1,000,000 w/ 3,500 Deductible 1,000,000 w/ 5,000 Deductible 1,250,000 w/ 5,000 Deductible 1,500,000 w/ 5,000 Deductible 1,750,000 w/ 5,000 Deductible 2,000,000 w/ 5,000 Deductible 2,250,000 w/ 5,000 Deductible 2,500,000 w/ 5,000 Deductible

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.

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.

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.

Civil Authority:

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.

Agency and Talent Re-Shoot Costs:

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.

Strikes or Civil Protest:

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:

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

Unscheduled

City/Other Special Certificates:

Excluded Included

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

Waiver of Subrogation:

Excluded Included

Primary & Non-Contributory Wording Occasionally Required by Locations

Abuse & Molestation:

Excluded 50,000 / 100,000 100,000 / 200,000 500,000 / 1,000,000 1,000,000 / 1,000,000

Each Claim / Aggregate

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.

Notes