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Company Info
General Info
Additional Questions
Additional Questions 2
Fraud Page
Confirmation
Section 2: GENERAL INFORMATION
Name of Event:
Date of Events: Starting from -
Date of Events: Ending to -
Time(s) of Event:
Location of Event:
Name of Facility:
Does the facility carry liability insurance?
Yes
No
Description of Event:
Is this event:
Indoor
Outdoor
If outdoors, is area fenced/enclosed?
Yes
No
Responsible for parking?
Yes
No
If yes, square footage of parking area?
Seating capacity of Event?
Estimated attendance per day?
Number of tickets printed?
Number of tickets sold to date?
Price of Admission?
Estimated Gross Receipts?
Estimated Total Payroll?
What are the Limits of Liability Requested?
General Aggregate:
Products Aggregate:
Each Occurrence:
Personal/Adv Injury:
Fire Damage:
Medical Payments:
Section 2b: ADDITIONAL INSURED TO BE ADDED TO THE POLICY
Name of additional insured:
Relationship with add. insured:
Address of additional insured:
Name of additional insured:
Relationship with add. insured:
Address of additional insured:
Name of additional insured:
Relationship with add. insured:
Address of additional insured:
Submit