What type of event is it?
10 K Run5 K RunAerobic ClassAerobic EventAmateur and/or Professional Association MeetingAnniversary Party - Open to the Public/No Admission ChargeAnniversary Party - No Charge for Admission / Invite OnlyAnniversary Party with Cover Charge or Ticket for AdmissionAntique ShowArchery - Amateur OnlyArt ShowAuctionAudio/Visual VendorAuto Show - Auto Static(Parked) OnlyAward PresentationBaby ShowerBadminton - Amateur OnlyBake SaleBalletBalloon ArtistBanquetBaptismBar MitzvahBartending Vendor at EventBaseball Alumni Game - Amateur OnlyBaseball Charity Game - Amateur OnlyBaseball Game - Amateur OnlyBaseball Game Fund Raising - Amateur OnlyBaseball Tournament - Amateur OnlyBasketball Alumni Game - Amateur OnlyBasketball Charity Game - Amateur OnlyBasketball Game - Amateur OnlyBasketball Game Fund Raising - Amateur OnlyBasketball Tournament - Amateur OnlyBat MitzvahBazaarBeauty PageantBelly DancerBelly Dancing ClassBelly Dancing GroupBicycle Event - No Racing/Off-road - Amateur OnlyBiking - No Racing/Off-road - Amateur OnlyBilliard EventBingo EventBird EventBird ShowBirthday Party - No Charge for Admission / Invite OnlyBirthday Party - Open to the Public/No Admission ChargeBirthday Party with Cover Charge or Ticket for AdmissionBlackjack EventBlock PartyBlues Music ConcertBoat Show - Dry Dock OnlyBoat Show - In Water - Static OnlyBocce - Amateur OnlyBody Building Event - Amateur OnlyBook SigningBooth - Sales/InfoBowling Tournament, Match, Class or Event - Amateur OnlyBoxing Alumni Match - Amateur OnlyBoxing Charity Match - Amateur OnlyBoxing Fund Raising Match - Amateur OnlyBoxing Match - Amateur OnlyBoxing Tournament - Amateur OnlyBreakfastBridal ShowerBrunchBrunch - Fund RaisingBusiness Meeting - No Charge for Admission / Invite OnlyBusiness Party - Open to the Public/No Admission ChargeBusiness Party - No Charge for Admission / Invite OnlyBusiness Party with Cover Charge or Ticket for AdmissionBusiness ShowCamera ShowCannabis EventCannabis information vendor - educational only NO CONSUMABLESCannabis VendorCar Show - Static(Parked) OnlyCar Show with Driving or RacingCard ShowCaricature SketchingCarnival - School Events with No Mechanical RidesCarolerCartoonistCasino NightCasino ShowCat ShowCatererCelebration of Life (Funeral Service)Chamber of Commerce EventChamber of Commerce MixerCharity AuctionCharity BenefitCharity Benefit RunCharity DanceCharity SaleCheerleading Competition - Amateur OnlyChef PersonalChess EventChoir - Indoor and/or OutdoorChoir - Indoor OnlyChristmas LightingChristmas Tree Lighting CeremonyChristmas Tree Lighting Decorating EventChristmas Tree SaleChurch MeetingChurch ServiceCivic Club MeetingClassical Dance ShowClassical Music ConcertClown - No Motorized VehiclesClown Troupe - No Motorized VehiclesComedianComedy ShowCompany/Corporate RetreatComputer ShowConcert - 50's MusicConcert - 60's MusicConcert - 70's MusicConcert - 80's MusicConcert - Blues MusicConcert - Celtic MusicConcert - Chamber MusicConcert - Classical Music - IndoorConcert - Classical Music - OutdoorConcert - Country MusicConcert - Folk MusicConcert - GospelConcert - Heavy MetalConcert - Hip HopConcert - Holiday MusicConcert - Jazz and Jam - IndoorConcert - Jazz and Jam - OutdoorConcert - Pop/Cover BandConcert - Punk RockConcert - R&BConcert - RapConcert - ReggaeConcert - RockConcert - SymphonyConcessionaire with CookingConcessionaire without CookingConference - Indoor and/or OutdoorConference - Indoor OnlyConsignment SaleConsumer ShowConvention - Indoor and/or OutdoorConvention - Indoor OnlyCornfield MazeCornhole Event - Amateur OnlyCostume ContestCountry & Western Event - No RidesCraft Show - Indoor and/or OutdoorCraft Show - Indoor OnlyCricket - Amateur OnlyCross Country (Running)Cue Based Sports Game - NOCCue Based Sports Tournament - NOCCurling - Amateur OnlyCycling (Distance)- No Racing/Off-Road - Amateur OnlyCycling (short term)- No Racing/Off-road - Amateur OnlyDance ClassDance CompetitionDance RecitalDance Show - ClassicalDebut of Product - In StoreDebutante BallDebutsDecathlonDecorator of EventDemolition DerbyDinnerDinner - Fund RaisingDisc Golf Event - Amateur OnlyDisc Golf Tournament - Amateur OnlyDJ - No Charge for Admission / Invite OnlyDJ Event - No Admission Charge/Open to the PublicDJ with Cover Charge or Ticket for AdmissionDodge Ball - Amateur OnlyDog EventDog ShowDragon BoatDrill Team ExhibitionEaster Egg HuntEducational ExhibitionElectronics ConventionEngagement Party - Indoor and/or OutdoorEngagement Party - Indoor OnlyEstate SaleEvent Performer(No Heavy Metal, Punk, Rap, Hip Hop or Hard Rock)Event PlannerEvent VendorEvent/Booth Set-Up ContractorExhibitor at EventExhibitor with SalesFace PainterFarmer's MarketFashion ShowFencing - Amateur OnlyFestival & Cultural Event - Indoor and/or OutdoorFestival & Cultural Event - Indoor OnlyFestival & Fair - No RidesField Hockey - Amateur OnlyFilm FestivalFilm ScreeningFilm Shoot - No Stunt Exposure AllowedFilm Shoot attendance 200 or less only (No Stunts)Film ShowingFirst CommunionFishing EventFive Kilometer RunFlag Football - Amateur OnlyFlea MarketFlower & Garden Show - OutdoorFlower and Garden Shows - Indoor OnlyFood VendorFood vendor (non-cannabis) at cannabis event NO CONSUMABLESFootball Alumni Game - Amateur OnlyFootball Charity Game - Amateur OnlyFootball Game - Amateur OnlyFootball Tournament - Amateur OnlyFraternity EventFraternity FundraiserFraternity PartyFrisbee Golf Event - Amateur OnlyFrisbee Golf Tournament - Amateur OnlyFun Obstacle RunFun RunFund Raising BreakfastFund Raising BrunchFund Raising DinnerFund Raising LunchFuneral ServiceGarden ShowGarden Show - Indoor OnlyGift ExchangeGolf Event - Not ProfessionalGolf Tournament - Daytime Only - Amateur OnlyGrad Night - Safe & Sober Overnight StyleGraduation - Social Reception / CeremonyGymnastic Competition - Amateur OnlyHandball - Amateur OnlyHarvest Festival - No Farm Implements or EquipmentHaunted House / AttractionHay RideHenna ArtistHighland Games - Amateur OnlyHikingHistorical Re-Enactment No WeaponsHockey Game - Amateur OnlyHoliday Event - Not Haunted - No Admission Charge/Open to the PublicHoliday Event - Not Haunted - No Charge for Admission / Invite OnlyHoliday Event - Not Haunted - with Cover Charge or Ticket for AdmissionHoliday Party - Not Haunted - No Admission Charge/Open to the PublicHoliday Party - Not Haunted - No Charge for Admission / Invite OnlyHoliday Party - Not Haunted - with Cover Charge or Ticket for AdmissionHome Show - Indoor and/or OutdoorHome Show - Indoor OnlyIce Skating Exhibition or ShowImpersonator - Celebrity or Holiday CharacterImpressionistIndoor Soccer - Amateur OnlyIronman Style TriathlonJazzercise ClassJazzercise EventJewelry MakerJob Fair - Indoor and/or OutdoorJob Fair - Indoor OnlyJuggler - No Fire/PyrotechnicsKarate (Non-Competitive) - Amateur OnlyKarate Meet - Amateur OnlyKarate Tournament - Amateur OnlyKayak/CanoeKick Ball - Amateur OnlyKioskLacrosse Alumni Game - Amateur OnlyLacrosse Charity Game - Amateur OnlyLacrosse Game - Amateur OnlyLacrosse Tournament - Amateur OnlyLadies Club EventLaser Tag Event - Indoor OnlyLectureLighting Tech Vendor for EventLive Action Role Playing (LARP)Livestock ShowLounge ShowLuncheonLuncheon - Fund RaisingMagic ShowMagicianMarathon - Walking or Running EventMariachi BandMarijuana Related EventMartial Arts Class - Amateur OnlyMartial Arts Event - Amateur OnlyMartial Arts Meet - Amateur OnlyMartial Arts Tournament - Amateur OnlyMath TournamentMeeting - Indoor and/or OutdoorMeeting - Indoor OnlyMeeting PlannerMemorial ServiceMenorah LightingMimeMixed Martial Arts Event - Amateur OnlyMMA (Training; No Sparring) - Amateur OnlyMobile Home ShowModern PentathlonMonte Carlo NightMotor SportsMovie Release PartyMud BoggingMusic Recording In Studio Premises OnlyNew Year's Eve Party - with Charge or Ticket for AdmissionNew Years Eve Party - No Charge for Admission / Invite OnlyObstacle RunOld Timer EventOrienteeringPaddleboard - Amateur Only, No Open WaterPageantParadeParade ParticipantParticipant in ParadePerformer at Event(No Heavy Metal, Punk, Rap, Hip Hop or Hard Rock)Personal ChefPhoto ShootPhotographerPickle Ball - Amatuer OnlyPicnic - No Pools or LakesPing Pong - Amateur OnlyPlatform Tennis - Amateur OnlyPlay - Theatre, Theater EventPlay ReadingPoet or Poetry ReadingPoker Event & Card GamePool TournamentPop-up MarketProcessioner in ParadeProduct DebutProfessional and or Amateur Association MeetingsPromPumpkin PatchPuppeteerQuinceaneraRacquet Ball - Amateur OnlyRecitalRegattaRemote Controlled Car Event-No Airborne-No Track ConstructionRetail Sales BoothRetail vendor (non-cannabis) at cannabis event NO CONSUMABLESRetirement Party - Open to the Public/No Admission ChargeRetirement Party - No Charge for Admission / Invite OnlyRetirement Party with Charge or Ticket for AdmissionRetreat - Company/CorporateReunion - Indoor and/or OutdoorReunion - Indoor OnlyRodeo EventRowingRugby Alumni Game - Amateur onlyRugby Charity Game - Amateur onlyRugby Game - Amateur onlyRugby Tournament - Amateur onlyRummage SaleRV Show - Static(Parked) OnlyScavenger HuntScenic Hike WalkSchool Band EventScouting Jamboree - No Overnight CampingSeminarSnooker GameSnooker TournamentSoap Box DerbySoccer (Season) - Amateur OnlySoccer Alumni Game - Amateur onlySoccer Charity Game - Amateur onlySoccer Game - Amateur onlySoccer Tournament - Amateur onlySocial Reception - Open to the Public/No Admission ChargeSocial Reception - No Admission Charge / Invite Only - Indoor OnlySocial Reception with Cover Charge or Ticket for AdmissionSocial Receptions - No Admission Charge / Invite Only - Indoor and/or OutdoorSoftball Alumni Game - Amateur OnlySoftball Charity Game - Amateur OnlySoftball Game - Amateur OnlySoftball Tournament - Amateur OnlySorority EventSorority FundraiserSorority PartySound Tech Vendor for EventSpeaking EngagementsSquash - Amateur OnlyStore OpeningStory TellingStreet ClosureStreet FairSwimming - Amateur Only, No Open WaterSymphony ConcertTable Tennis - Amateur OnlyTae Kwon Do ClassTae Kwon Do MeetTae Kwon Do TournamentTai Chi ClassTalent Show - No RapTap DancingTeambuilding (on ground only)TeleconferenceTen Kilometer RunTennis (Season) - Amateur OnlyTennis Alumni Game - Amateur onlyTennis Charity Game - Amateur onlyTennis Game - Amateur onlyTennis Tournament - Amateur onlyTexas Hold 'Em EventTheatrical Stage PerformanceTrack & Field - Amateur OnlyTractor PullsTrade Show - Indoor and/or OutdoorTrade Show - Indoor OnlyTrade shows - Cannabis info or educational only NO CONSUMABLESTriathlonTruck Show - Static(Parked) OnlyTruck Show with Driving or RacingUltimate Frisbee - Amateur OnlyUnion MeetingVacation ShowVendor at EventVendor, Food (non-cannabis) at cannabis event NO CONSUMABLESVendor, Retail (non-cannabis) at cannabis event NO CONSUMABLESVentriloquistVideo Game ContestVirtual EventVolleyball (Season) - Amateur OnlyVolleyball Alumni Game - Amateur onlyVolleyball Charity Game - Amateur onlyVolleyball Game - Amateur onlyVolleyball Tournament - Amateur onlyVoter RegistrationWagon RideWalking / Hiking TourWalking EventWalking TourWater Polo - Amateur OnlyWeddingWedding BartenderWedding PlannerWedding ReceptionWedding RehearsalWedding VendorWeight Lifting Event - Amateur OnlyWiffle Ball - Amateur OnlyWine TastingWrestling - Scripted/PlannedWrestling Alumni Match - Amateur onlyWrestling Charity Match - Amateur onlyWrestling Event (Amateur Only)Wrestling Match - Amateur onlyWrestling Meet - Amateur onlyWrestling Tournament - Amateur onlyYard SaleYodelerYoga ClassYoga EventZombie Run

Where is your event?
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Date of coverage you need

Combined Daily Attendance

How many years of experience do you have promoting or putting on this type of event?

Have you ever experienced any claims or lawsuits during that time?
YesNo

What are the dates of your event?

What are the hours of your event?

Do you need additional days for set up of tear down of this event?
YesNo

If so, please list the dates

What is the maximum estimated attendance for each date?

Is there a minimum age for the attendees at your event?

What is the name of the venue where you event is being held?

What is the address?

Is this an indoor or outdoor event?
YesNo

Is there going to be alcohol sold at your event?
YesNo

Who is selling (you, the venue, or are you bringing in a 3rd party to sell?)

If a 3rd party is selling alcohol, do they have their own retail liquor coverage and name you as additional insured?

Who is providing the security at your event (you or the venue?)

How many security at your event?

If you are hiring a 3rd party security company, do they have their own insurance and name you as additional insured?

Will there also be police at your event?
YesNo

If so, how many officers?

Will all guests, attendees, and performers be screened by metal detectors at all entrances and exits?
YesNo

Please provide a list of all the performers and the genre of music being performed by each artist?

Are you having to hire any other subcontractors? (example: Production Companies, 3rd party caterers, etc…) Also, will they be naming you as additional insured?)
YesNo

Will there be any vendors at your event? (example: food or merchandise).
YesNo

If so, how many food vendors?

If so, How many merchandise vendors?

Will the vendors name you as additional insured?
YesNo

Will there be any fireworks or pyrotechnics?
YesNo

Will there be any rides or inflatables?
YesNo

If so, does the ride or inflatable vendor stay onsite and run that operation and also name you as additional insured?)

What activities will be taking place? (just need a general description of what will be going on at your event)

What is your cost/budget to put this event on?

What is your estimated revenue? (example: total ticket sales, venue cost, etc…)

What is the name of your event?

Is there assigned seating or just general admission?
YesNo

Is there any camping or events that go past 2am
YesNo

Please provide any additional details that you might think is important?

Is the venue just requiring the standard limits of liability or do they require coverage like: excess liability, Waiver of Subrogation, Primary & Non-Contributory Wording, Hired/Non-Owned auto coverage, etc…)?
YesNo

Please list the names and addresses of those parties requesting to be named as Additional Insured’s?

Alcohol Coverage
NoneHost LiquorRetail Liquor

Coverage Limits
$1,000,000 Occurrence / $2,000,000 Aggregate$1,000,000 Occurrence / $5,000,000 Aggregate$2,000,000 Occurrence / $2,000,000 Aggregate$2,000,000 Occurrence / $3,000,000 Aggregate$2,000,000 Occurrence / $4,000,000 Aggregate$2,000,000 Occurrence / $5,000,000 Aggregate

$5,000 Medical Payments$10,000 Medical Payments

$1,000 Deductible$500 DeductibleNo Deductible

Need a Waiver of Subrogation?
YesNo

Need Hired & Non-Owned Auto?
YesNo

I understand that the dates selected above are the only dates that will be covered by this policy. Each date is midnight to midnight. I have selected all set-up and clean-up days necessary for my event.