ProductionInsurance.com
  A Service of Supple-Merrill & Driscoll, Inc.

  

  

 

 Annual Show Organizer Application Instructions

  1. Please complete and submit this online application for a free, no-obligation quote.

  2. Please be sure to provide all required information in order to receive a quotation. 

 

  Program Information

This is a secure application.  Strong cryptography is implemented via the Secure Sockets Layer protocol.  Our Privacy Policy.

  PDF Application (Fillable)

 
 

( indicates required information)

Applicant Information

Name of Company / Organization:
Entity:

Full Name of Contact:
Number:
Fax:
Street Address:
City, State: ,
Zip/Postal Code:

Email:

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

Website:
Applicant Type:

 

Loss History
Any Prior Event With Any Losses of Any Kind?

If Yes, Please Provide Details:

 

Show Details

Show Name:
Organizer's Cost/Budget:

Show Description:

If Music Will Be Involved, Please Describe Type.

Is Show for and/or include nationally known/recognized person(s)?

Private Armed Security Guards:

Private Armed Security Guards make the event ineligible for our program

 

Dates

Setup Date(s):

to

If Any

The period before the event to arrange.

Attendees will not be present during the setup.

Select up to 7 days at no additional premium.

Event Date(s):

to

The duration the actual event will take place (not including setup and teardown.

Attendees will be present during the actual event.

Tear Down Date(s):

to

If Any

The period to dismantle after the event.

Attendees will not be present during tear down.

Select up to 7 days at no additional premium.

Event Hours:  to
Total Number of Days:

 

Venue Details

Location where Show takes place.

Venue Name:
Address:
City:
State:
Zip:
Event Location:

 

General Liability Limits

Per Occurrence Limit:

The Aggregate, or Total Policy Limit, is Unlimited.

 

Spectators & Participants
Total Spectators:

Attendance

Average Daily Attendance:
Medical Coverage for Spectators:
Medical Coverage for Participants:

 

Event Cancellation

Cancellation:

Limit is Event Budget

 

Vendor's Liability

Option to Extend Coverage to Vendors

# of Exhibitors:

No Sales

# of Concessionaires:

Non-food Sales

# of Concessionaires:

Food Sales

# of Attractions:

Performers

 

General Liability

Liability Options:

Blanket Additional Insured

Hired & Non-Owned Automobile Liability

Liquor Liability

Waiver of Subrogation

 

Property Coverage

Third Party Property Damage:

Rented Equipment:

$100,000 Max

 

Notes

 

 

 

 

Terms and Conditions

Please carefully review the Terms and Conditions below:

  • Please read all exclusions indicated on quotation.

  • The quotation received is not binding on the Insurer in any way.

  • By clicking 'Submit Application' you are not agreeing to purchase coverage.  Via email, you will receive a free, no-obligation insurance quotation.

  • 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.
  • Please note that once coverage is bound, the policy cannot be cancelled.

  • The insurance quotation will be based solely on the coverages and limits selected on this application.

  • Please ask your Supple-Merrill & Driscoll, Inc. representative to explain coverage details, exclusions, limits or other provisions of any insurance policy.

Type your name below, to indicate that you have read

and accepted the Terms and Conditions above:

 

 

 

  

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ProductionInsurance.com is the entertainment division of Supple-Merrill & Driscoll, Inc.  California License 0517777.

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