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 ProductionInsurance.com

  A Service of Supple-Merrill & Driscoll, Inc.

 

  

 

 Venues Insurance 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:

 

Underwriting Information

Operations:
Description of Business/Operations:

 

Insurance History
Any insurance declined or cancelled in the past 3 years?

Yes  No

Any prior insurance coverage?

Yes  No

Any loss in the past 3 years?

Yes  No

 

General Information
Typical Types of Events:

Will any events have stunts, pyrotechnics, or other hazardous activities?

Yes  No

 

Procedures
Is a standard contract used with Tenant Users/Event Organizers?

Yes  No

Is facility compliant with City, State and County Building Safety Codes?

Yes  No

Does the venue have security personnel or bouncers?

Yes  No

Are Security personnel subcontracted from a third party?

Yes  No

Are certificates of insurance obtained?

Yes  No

Number of Security Personnel:

 

General Event Information
Estimated number of events/shows for the upcoming year:

Average number of attendees per event:

Capacity:

Maximum Allowable Attendees Per Event

 

Admissions
   

Previous 12 Months

Upcoming 12 Months

Other Than Concerts:

Concerts - Other Than Rap / Hip-Hop:

Concerts - Rap / Hip-Hop:

 

Revenue
   

Previous 12 Months

Upcoming 12 Months

Concession Sales - Other Than Liquor:

Ticket Sales:

Liquor Sales:

 

Venue Details
Venue #1
Name:

Street Address:
City:
State:
Zip/Postal Code:
Venue Capacity:

Venue #2
Name:
Street Address:
City:
State:
Zip/Postal Code:
Venue Capacity:

Venue #3
Name:
Street Address:
City:
State:
Zip/Postal Code:
Venue Capacity:

 

Coverage Term

Effective Date:

Annual Policy Period

 

Inland Marine

Property & Equipment Coverages

Owned Equipment, Props, Sets, Wardrobe:
Equipment, Props, Sets, Wardrobe:

Deductible

Rented Equipment, Props, Sets, Wardrobe:

Office Contents:

Office contents and related equipment, furnishings, fixtures, improvements & betterments, inventory.

Business Income/Extra Expense:

Resumption of Business Operations:

Extra expense sustained due to the necessary suspension of business operations including relocation expenses and costs to equip and operate any replacement or temporary location.

Hired & Non-owned Auto Physical Damage:

Per Vehicle / Aggregate Limit

EDP:

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:

Attaches to EDP and provides limited coverage for computer viruses.

Accounts Receivable:
Valuable Papers and Records:
Money & Securities:
Waiver of Subrogation:

Earthquake:

Due to capacity constraints, limits above 250,000 will require carrier approval.

 

General Liability

Limits:

Occurrence / Aggregate

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.

Fire Legal:

Medical Payments:

Blanket Additional Insureds / Certificates of Insurance:

Included

Blanket additional insureds allow for unlimited certificates to vendors and locations. City certificates, other special certs, and waivers of subrogation are picked up under their respective coverages.

City/Other Special Certificates:

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

Waiver of Subrogation:

Primary & Non-Contributory Wording Occasionally Required by Locations

Liquor Liability:

Occurrence / Aggregate

Recommended for Events with Alcohol

 

Automobile
Hired / Non-Owned Liability:
Waiver of Subrogation:
Number of Loaned or Donated Vehicles / Days:

# of Vehicles 

# of Days

Cost of Hire:

Mobile Studios and Film Trucks

Other Than Mobile Studios and Film Trucks

 

Excess Liability

Limits:

Per Occurrence/Aggregate

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

 

 

 

 

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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