Short Term Production Insurance Quote Get a Short Term Production Insurance Quote by completing this simple form. Step 1 of 6 16% What is Your Name?(Required) First Last What is your role in the operation?CEO, Organizer, Executive Producer, Director, Owner, Marketing, Secretary...What is the full legal name of your company/operation?(Required)What type of organization is this?(Required)SelectCorporation - For ProfitCorporation - Not For ProfitLLC - For ProfitLLC - Not For ProfitIndividual - Sole ProprietorTrustDescribe your organization's role & responsibility in event(Required)Hosting, producing, sponsoring, vendor at an event...What is the mailing address of the organization?(Required) Street Address City State / Province / Region ZIP / Postal Code Phone(Required)E-mail(Required) FaxHahaha who still uses faxes?Does the event have a website?(Required) Yes No Please enter the event's website here. What type of Event is this?(Required)Please check all that apply Anniversary Party Bar/Bat Mitzvah Beer Garden/Beer Tent Block Party Birthday Party Car Show Competition or Show Concerts/Musical Performance Conventions/Trade Show/Exhibit Festival Flea Market Film Shoot Fund Raiser Graduation Party Individual Vendor Booth at a larger event Motor Vehicle Race/Show Music Video Shoot Parade Party/Social Event Photo Shoot Picnic Sporting Event/Tournament Swap Meet Sweet 16 Theatre Performance Wedding/Wedding Reception Other If OTHER please explain(Required)What type of shoot is this?AnimationCell Phone ProductionsCommercialCommunity TV InterviewCorporate VideoDemo Reel ShootDigital VideoDirect Sale VideosDirector's ReelDocumentaryEditingEducational & Training FilmExperimental FilmFeature Film (for theatrical release)Feature Film (not for theatrical release)Festival ReelFilm PromotionIndependent Feature, Low BudgetIndustrialInfomercialInstructional VideoInternet ProductionsLive Action ShotMiscellaneous ProductionMotion PictureMusic VideoNon Airing PilotPhotography ShootPick-up ShootPoint of Sale VideoPost-productionPre-productionProductions for miscellaneous mediumPromotional VideoPublic Access ProgramPublic Service AnnouncementReality Based TV ShowSAG ExperimentalSAG Limited ExhibitionSAG Modified Low BudgetSales VideoShort FilmSoap OperaSpec CommercialSpec ProductionTelevision PilotTelevision SeriesTelevision SpecialThesis FilmTrailerTraining VideoVideo BiographyVideo Game ShootVideo Location SurveyVideo Shoot (Miscellaneous)What is the Title/Working Title of this productionWhat is the name of the music artist(Required)What Music Category is this for?(Required)SelectAlternativeBluesChildren's MusicClassicalCountryElectronicFolkHard Rock/Heavy MetalHip Hop/RapJazzLatinNew AgeOperaPopR&B/Soul (other than hip-hop, rap)ReggaeRockWorldWhat is the title of the song?(Required)Please provide a detailed description of the event.(Required)Please provide a detailed SYNOPSIS of the story.(Required)Please provide a DETAILED breakdown of the shoots.(Required)Include a location types, and details on the types of scenes to be shot. Will any of the following be involved in the shoot?(Required) NONE OF THESE Live gangster rap music Hard-Core or Soft-Core pornography Stunts Pyrotechnics Aircraft, boats, helicopters, motorbikes, snowmobiles, ATVs Animals Race tracks or race courses Blanks, squibs, guns Other hazardous activities Please provide details on the above.(Required)Details means details: usage, frequency, breeds, handlers, stent teams... Is this event part of a larger function?(Required)Like a carnival, a street fair.... Yes No If “Yes,” describe(Required)Is there an admission charge?(Required) Yes No If “Yes,” what is the cost of admission per person?(Required)What date will the event start?(Required) MM slash DD slash YYYY What date will the event end?(Required) MM slash DD slash YYYY What date do you need coverage to start?(Required)Please account for set up/load in MM slash DD slash YYYY What date do you need coverage to end?(Required)Please account for take down/clean up MM slash DD slash YYYY If event dates differs from desired coverage dates, explainStart Time (HH:MM AM/PM)(Required)End Time (HH:MM AM/PM)(Required)What is the name of the venue that the function is taking place at?(Required)What is the full address of where the event will take place? Street Address City State / Province / Region ZIP / Postal Code What type of location is this?(Required)Check all that apply. Arena Catering Hall Convention Center/Hotel Fair Grounds Film Studio Liquor Licensed Establishment Other Private Residence School Sound Stage Stadium Theater if "Other" please explain in detail.(Required)Is the event indoors or outdoors?(Required) Indoors Outdoors Event DetailsESTIMATED ATTENDANCE PER DAY(Required)TOTAL Attendance for ALL days.(Required)What is the maximum capacity of facility?(Required)How many people can the venue hold?Average age of the attendees?(Required)Give us your best approximation.Is this event invite only or open to the public?(Required) Invite Public How many years has the event been previously held?(Required)Enter 0 (zero) if this is the 1st year for the event.What was the actual total attendance for Prior Year’s event?(Required) Does facility you are holding the event at require a contract for usage?(Required) Yes No Will you be subcontracting any work for this event?(Required) Yes No What type of labor will be performed by subcontractors?(Required)What forms of protection are in place with subcontractors?(Required) Formal Contracts that require them to hold us harmless and indemnify us They are required to maintain liability insurance They are required to name us as additional insureds on their liability They are required to maintain workers compensation None of the above Liability DetailsWhat liability limit do you need?(Required) $500,000 $1,000,000 $2,000,000 OTHER If OTHER please specify(Required)What is the total cost to produce this event?(Required)Enter "0" (zero) if noneWhat is the projected revenue from this event?(Required)Enter "0" (zero) if nonePlease specify which of the following will be present.Will the event include any of the following?(Required)Please check all that apply Aircraft including drones Animals (other than pet contests & shows) Archery Camping/Overnight exposure Cannabis including but not limited to edibles, CBD, THC etc Cattle drives Childcare operations Firearms/Ammunition/Weapons of Any Kind Fireworks/Pyrotechnics Food vendors Golf Carts Hay/Wagon Rides Inflatables Mechanical amusement rides Medical Exams and/or Vaccines Motorsports Obstacles Open Flames Open water exposure Paintball Parade Rock climbing walls Rodeos Tattooing/Body piercing Temporary Skating/skiing/skateboarding structures NONE OF THE ABOVE Please provide details on the above.(Required)Are Vendors, Attraction Owners and Performers required to carry their own insurance?(Required) Yes No If “Yes,” what liability limit do you require them to carry?(Required)Will concessionaires provide you with certificates evidencing products liability with your organization named as Additional Insured?(Required) Yes No NA SecurityIs security provided by(Required)Check all that apply There is no security Independent Contractors Your Employees On-Duty Police Off-Duty Police Guard Dogs Describe the security measures.(Required)Who contracts security?(Required) Facility You , The Applicant Number of Security Personnel to Be Present?(Required)If security provided by Independent Contractors, are they required to carry their own insurance?(Required) Yes No Will there be any Musical Performers or Entertainers at the event?(Required) N Y MUSICAL/ENTERTAINMENTPerformer Entertainer Name?(Required)Type of Music(Required)AlternativeBlue GrassBluesChristianClassicalCountryDJ OnlyGospelElectronicHeavy MetalJazzPop / Yop 40PunkRap & Hip HopR&B / SoulRockLocal or National Entertainer?(Required) Local National Add a 2nd performer? Y Performer 2Performer Entertainer Name?(Required)Type of Music(Required)AlternativeBlue GrassBluesChristianClassicalCountryDJ OnlyGospelElectronicHeavy MetalJazzPop / Yop 40PunkRap & Hip HopR&B / SoulRockLocal or National Entertainer?(Required) Local National Add a 3rd performer? Y Performer 3Performer Entertainer Name?(Required)Type of MusicAlternativeBlue GrassBluesChristianClassicalCountryDJ OnlyGospelElectronicHeavy MetalJazzPop / Yop 40PunkRap & Hip HopR&B / SoulRockLocal or National Entertainer? Local National Add a 4th performer? Y Performer 4Performer Entertainer Name?(Required)Type of MusicAlternativeBlue GrassBluesChristianClassicalCountryDJ OnlyGospelElectronicHeavy MetalJazzPop / Yop 40PunkRap & Hip HopR&B / SoulRockLocal or National Entertainer? National Local EntertainmentIs Dancing Permitted at this event?(Required) Yes No Sporting EventsWill there be any Athletic games at the event?(Required) No Yes Is this a Professional or Amateur event?(Required) Professional Amateur Number of Games(Required)Number of Spectators(Required)How many Adult Participants / Players?How many Youth Participants / Players?(Required) Do you need Liquor Liability for this event.(Required)Liquor liability protects you against claims or suits that arise from the incidental selling or serving of alcoholic beverages. This can include fights, falls, and even DUI's or car accidents. Yes No Liquor LiabilityWhat is the ESTIMATED number of attendees consuming alcohol each day?(Required)Will you be the sole alcohol vendor at the event?(Required) Yes No If “No,” List number of other Vendors serving alcohol(Required)Are all participating alcohol Vendors required to carry minimum Liquor Liability Limits for the Event?(Required) Yes No If “Yes,” what is the Minimum Requirement(Required)SELECT$1,000,000$2,000,000$3,000,000$4,000,000$5,000,000Will alcohol be dispensed by a Professional Bartender?(Required) Yes No If “No,” describe how and by whom alcohol will be dispensed:(Required)Describe training and or experience of the people serving alcohol.(Required)What measures are in place to prevent service of alcohol to minor and/or intoxicated persons?(Required)Is a Liquor License required for this event?(Required) Yes No Do you have a valid Liquor License for this event?(Required) Yes No How many bars, stations or areas will alcohol will be dispensed at?(Required)Will alcohol consumption confined to this (these) areas?(Required) Yes No If “No,” describe(Required)Will there be an open bar?(Required) Yes No Will liquor sold by the drink?(Required) Yes No What is the average cost per drink?(Required)What is you estimated DAILY Alcohol Gross $ Sales?(Required)Is BYOB (Bring your own bottle) permitted?(Required) Yes No FoodWill food be sold or served?(Required) Yes No If “Yes,” describe type of food available(Required)What is you estimated DAILY Food Gross $ Sales?(Required) Final UnderwritingWhat are your total Estimated GROSS Receipts for entire period, including admission, food, beverage and concessions?(Required)Do you need to name any additional insured entities onto this coverage?(Required) Yes No Additional InsuredsAdditional Insured Name(Required)Additional Insured Address(Required)Interest In the Event(Required)Add a 2nd Additional Insured? Yes please! 2nd Additional InsuredAdditional Insured Name(Required)Additional Insured AddressInterest In the Event(Required)Add a 3rd Additional Insured? Yes please! 3rd Additional InsuredAdditional Insured Name(Required)Additional Insured Address(Required)Interest In the Event(Required)Prior InsuranceHow many years has this event been continuously insured?(Required) 0 1 2 3 or more Has any insurance carrier cancelled or refused coverage?(Required) Yes No If “yes”, please explain.(Required)Last Year's Insurance InformationTotal Premium(Required)Carrier & Policy #(Required)Total # of Claims(Required)Total Claim $'s Paid(Required)Prior year (2 years ago)Total Premium(Required)Carrier & Policy #(Required)Total # of Claims(Required)Total Claim $'s Paid(Required)Prior year (3 years ago)Total Premium(Required)Carrier & Policy #(Required)Total # of Claim(Required)Total Claim $'s Paid(Required)Final AuthorizationWhat other insurance coverage do you need for this event?(Required) NONE Auto Liability Abuse & Molestation Damage to Rented Premises Owned Equipment Participant's Accident & Medical Props, Sets & Wardrobe Rented Equipment Spectator's Accident & Medical Third Party Property Damage Umbrella/Excess Liability Waiver of Subrogation Workers Compensation Do you require Cast & Crew Extra Expense coverage?(Required) Yes No Select required Cast & Crew Coverge(Required) Covered Person Extension (without sickness) Covered Person Extension (including sickness) Family Bereavement Will you be transporting passengers for a fee?(Required) No Yes What Auto Liability Limit do you need?(Required) $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 What Abuse & Molestation Limit do you need?(Required) $50,000 $100,000 $500,000 $1,000,000 What Damage to Rented Premises Limit do you need?(Required) $100,000 $200,000 $300,000 $500,000 $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 What Owned Equipment Limit do you need?(Required) $10,000 $25,000 $50,000 $100,000 $150,000 $200,000 $250,000 Other What Workers Compensation Limit do you need?(Required) $100,000 $500,000 $1,000,000 What is the operation's Federal Tax ID Number?(Required)This is required for the workers compensation.What is the total payroll, in dollars, being generated from this event?(Required)This is required for the workers compensation.Please provide a description of the owned equipment to be insured.(Required)How will equipment be transported?(Required)Who will be transporting the equipment?(Required)Where will the equipment be stored?(Required)Will any equipment be left in an unattended vehicle?(Required) No Yes What Rented Equipment Limit do you need?(Required) $10,000 $50,000 $100,000 $250,000 $500,000 Other What Props/Sets/Wardrobes Limit do you need?(Required) $25,000 $50,000 $100,000 $250,000 $500,000 $750,000 $,1000,000 $1,500,000 $1,500,000 $2,000,000 Other What type of equipment are you renting?(Required)What Third Party Property Damage Limit do you need?(Required) $250,000 $500,000 $1,000,000 $1,500,000 $2,000,000 Other What Accident & Medical Limit do you need?(Required) $25,000 $50,000 What Umbrella / Excess Liability Limit do you need?(Required) $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 Other What is your company's Federal Tax ID Number?(Required)This is required for the workers comp you requested.What is your total projected payroll for this event?(Required)How many full time employees?(Required)How many part time employees?(Required)Do you have any specific insurance requirements that you need to satisfy?(Required) No Yes, I will upload them Yes, I will paste them below Yes, I will paste them below & upload them because that's just how I roll. If you have insurance requirements you need to satisfy, please upload them here.(Required) Drop files here or Select files Accepted file types: doc, pdf, jpg, Max. file size: 6 GB, Max. files: 4. If you have insurance requirements you need to satisfy, please paste them here.(Required)If you have you have a flyer or marketing materials for the event, please upload them here. Drop files here or Select files Accepted file types: doc, pdf, jpg, Max. file size: 6 GB, Max. files: 4. Enter Your Name(Required)Enter your name to acknowledge the following: 1. No Mechanical Devices or Machinery with Moving Parts 2. No Buildings Over One Story 3. No Chutes, Slides, Trap Doors, Movable or Sharply Inclined Floors 4. No Use of Live Animals 5. No Physical Contact or Jumping Out at Patrons by Actors 6. Warnings Posted for Pregnant Women and/or Those with Heart Conditions 7. No Open Flames 8. All Steps to be well Lighted and Include Handrails 9. Adequate Emergency Lighting 10. Exits Well Marked 11. Buildings Must Meet or Exceed Local Zoning and Fire Codes 12. Hayrides Must Be Tractor Drawn – No Horse Drawn Hayrides 13. Hayrides Must Be On Private Property – No Public Roads
