Cossio Insurance Agency Party Equipment Rentals
Insurance Information
Current Policy Expiration Date:
Current Insurance Company:
Has any insurer ever canceled or refused coverage?
Yes
No
If yes, explain:
Have you had any claims within the last 5 years?
Yes
No
If yes, explain:
DESCRIPTION OF OPERATIONS
Please check which best describes the nature of your operation:
Rental Operations
Inflatable Fun Facility
Party Rental Stores
Other
If Other, describe:
Please make sure that you have completed everything to the best of your knowledge before going to the next page.