Click Here For Policy Features Event Cancellation Application Policy requires that you apply for a quote at least 21 days in advance of your event. Once quoted, a 15 days advance purchase is also required. Step 1 of 5 20% InstagramThis field is for validation purposes and should be left unchanged.Policyholder InformationYour Company NamePlease, do not type in ALL CAPS anywhere on this form.This is NOT the place to put the event name. You will be asked for that information on the next screen.----------Insurance Brokers- DO NOT put your name here. You will be asked for that information on the next screen. Your Full Name*First & LastAddress* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Phone Number (Preferably Mobile)*Can this phone accept texts? Yes No Click Yes if you would like reminder texts about your quote & policy.Email (If you are an insurance broker, use your email & not your clients)* Enter Email Confirm Email This field is hidden when viewing the formObsolete 8-20-19 WebsiteHow many years of experience do you have?*Who referred you to us?Are you an insurance agent/broker applying for a quote on behalf of your client?* Yes No For Insurance Agents & Brokers OnlyYour Insurance Agency NameRemember to enter YOUR email address above, NOT your client's email. Otherwise they will receive automatic notifications and our quote instead of you.Agents First NameAgents Last NameAddressIf you're one of our regular brokers, you can skip this part. We'll look you up by your name and email. If you're new, or your address information has change, please continue. 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Event DetailsName of Event*Type of Event (Convention, Concert, Festival, Sports, etc.)*Names of all performing artists, speakers, etc.*Describe your experience in producing events like this one*Event Dates*Estimated Daily Attendance*Total Number of Shows/Performances*Event Start Time*Event End Time*Detailed Event Description*Is the event outdoors?* Yes No Would bad weather cause cancellation of your event?* Yes No Describe what type of cover/roof there will be over the performance area*What allowance has been made for travel delays?*What allowance has been made for setup time?*Any rain dates?* Policy Limits & CoverageGross Revenue from your event*Gross Revenue: All monies paid or payable to you from every source arising out of the event.Total Event Expenses*Total Expenses: The total of all your costs and charges from the planning, preparation and staging of the event.Do you want a quote on Gross Revenue or just your expenses?* Revenue Expenses Do you want to include coverage for Artist/Performer/Speaker Non-Appearance?* Yes No Provide details of all persons to be insured: Names, ages, duties.*Describe their travel itinerary. Where are they traveling from? Method of transportation? Date & time of arrival?*Are you aware if any of these persons have a history of not appearing?*Are you aware if any of these persons are suffering any medical condition?* Venue InformationName of Venue*Venue Contact's First & Last name*Venue Contact's Email Venue TelephoneVenue FaxAddress* Mailing Address City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Will the event venue require any type of construction work? Explain a yes answer.* Additional Event DetailsYour previous Insurance company*Premium PaidList any previous losses, insured or not*Upload a copy of your venue contract and your artist contract.Acceptable file types: pdf, jpg, gif, png, doc, docx, xls, xlsx. Maximum File Size: 128MB. Drop files here or Select files Accepted file types: pdf, jpg, gif, png, doc, docx, xls, xlsx, Max. file size: 256 MB. Any additional information we need to know?