Party Equipment Rentals

Helpful Tip: You will create a password at the end of this page that will allow you to come back at any time to fill out your application!

Section 1: POLICY RECOMMENDATIONS

(Please check any you are interested in)

General Liability
Accident Medical
Earthquake
Inland Marine
Worker's Compensation
Commercial Auto
EPLI
Flood
Hired & Non-Owned Auto
Umbrella
Abuse/Molestation
Cyber Liability

Submission Requirements
1) Loss Runs (5 years)
2) No loss letter if operating with no insurance
3) Copy of Rental Agreement / Waiver
4) Safety Rules
5) Pictures of signage with hold harmless wording (Pay for Play Only)
6) Copy of Taxes or Schedule C

Section 2: COMPANY INFORMATION

How did you hear about us?

Are you an Event Rental Systems or Inflatable Office customer? (You may be eligible for a discount) Yes No

Corporate Name:

Business Name:

First Name

Last Name

Date of Birth:

FEIN/SS#:

Phone Number:

Fax Number:

Email Address:

Website:

Entity Type: Examples: Individual: Jane Doe DBA Jane's Bouncers, Partnership: Jane Doe & John Smith, Corporation: C Corp or S Corp, LLC: Jane's Bouncers LLC

Year Business Started (Month/Year):

Years of Management Experience:

Type of Management Experience:

Do you ever process payment cards? Yes No

Estimated annual number of payment card transactions:

Mailing Address

Mailing Address:

City:

State:

Zip code:

Location Address

Location Address:

City:

State:

Zip code:

Operation type? Your employees present at event
with operators Not operated by your employees
without operators Some events are operated by your staff & some events are not
both

With Operators - Projected Annual Gross Sales: $

Without Operators - Projected Annual Gross Sales: $

Desired Effective Date:

Describe your operations- Check all that apply:
Backyard Birthday Parties Parks Corporate Events Street Fairs Carnivals
Events where you charge each participant Other:

Do you or your company own/operate any Street Fairs, Carnivals or Midways?
Yes No

Create Password (this will allow you to access you application at a later time) :

Please attach the signage or waiver for your Corporate Events

Please attach the signage or waiver for Street Fair Events

Please attach the signage or waiver for your Carnival Events

Please attach the signage or waiver for your Events where