Special Events

Inflatables

Will there be any Inflatables or Bounce-Houses at the event?

Inflatables are not part of our Special Events coverage and selecting such will decline this quote.

However, if you complete the rest of the form and submit it, it will be reviewed by an underwriter.

Agent Information

Agency Name

-OR-

Agent Lookup Code

Please select a location

Agent Names

Agent Name (first and last)

Phone:

Fax:

Agent Email:

Insured Information

Insured Name:

Insured Email:

Form of Business

Insured Address

Suite, Unit, Floor, etc (optional)

Insured City

Insured State:

Insured Zip

NOTE: Cannot write special events in Philadelphia.

Risk Details

Event Address

Suite, Unit, Floor, etc (optional)

Event City

Event State

Event Zip

Number of people attending:

Event Start Date:

Duration of event:

Event start time:

Event end time:

Limit Required:

Does the event require Host Liquor? (Click if Yes)

Will a third-party be serving the liquor? (Click if Yes)

Is there a charge per drink? (Click if Yes)

Is a government entity one of the named insureds? (Click if Yes)

Is security or crowd control provided by the prospective insured? (Click if Yes)

Is the party for someone younger than 21?

Event Classification

Please select your work from the appropriate field(s) below.

NFP = Not For Profit / NOC = Not Otherwise Classified

Please select the type of event:

Is the event hosted by the insured? (Click if Yes)

Is this event Not-For-Profit? (Click if Yes)

Are there lead and follow-up guides? (Click if Yes)

Are there separate entrances and exits? (Click if Yes)

Are there unlit stairs? (Click if Yes)

Is fire used in the Haunted House? (Click if Yes)

Are there any moveable floors? (Click if Yes)

Are there any sinking floors? (Click if Yes)

Is there any touching of spectators? (Click if Yes)

Are there any electric shock devices? (Click if Yes)

Any cardboard construction? (Click if Yes)

Are horses involved? (Click if Yes)

Is the concert played by rock bands? (Click if Yes)

Is the music Electronic, Gothic, Hard Core, Heavy Metal, Hip Hop, or Rap? (Click if Yes)

Will Concert have high profile entertainers? (Click if Yes)

Is this related in any way to Ultimate Fighting or Mixed Martial Arts? (Click if Yes)

Is this is a celebrity wedding? (Click if Yes)

Please provide a brief description of your event:

Additional Exposures

Additional Insureds (Click if Yes)

Type of Additional Insured:

Number of Additional Insureds:

Add Waiver of Subrogation?

Is Waiver of Subrogation required by contract?

Number of Waivers needed:

Additional Set-up / Take-down days? (Click if Yes)

Sum of additional set-up and take-down days:

Will there be a fire works exhibition/show in conjunction with the event? (Click if Yes)

Any losses in the last 5 years? (Click if Yes)

Number of losses in the last 5 years:

Any loss over $10,000? (Click if Yes)

Terrorism Coverage

Will insured need Terrorism Coverage? (Click if Yes)

Commission

What commission would you like for this account?

Additional Comments

Any Additional Comments:

Special Events Online Quote