Professional Small Business Package

Professional Small Business Package
Click here for Insurance Terms & Definitions.
APPLICANT INFORMATION
How did you hear about us?*
Select how you found our website.
Insured Name*
The name of your production company or entity (or individual name if not incorporated) you would like to insure. Use the same name as on your rental quote.
Entity Type*
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*

Confirmation Email
Website

Business Details - Exposure
What is your estimated gross sales for the next 12 months? *
(Include all your company's locations). Gross sales are the total sales that a business receives from the products and services that it sells before deducting customer discounts, returned merchandise and allowances for doubtful accounts.
What is your estimated payroll expense for the next 12 months for yourself, your full-time, part-time and temporary employees? *
(Do not include subcontractors)
Including yourself, how many full-time, part-time, and temporary employees does your business have? *
(Do not include subcontractors.)

Insurance History
Has your business ever had any commercial insurance cancelled or rescinded? This does not include a prior cancellation for nonpayment of premium.*

YesNo
Based upon your knowledge and the knowledge of your business’s current and past partners, officers, directors and employees, during the last five years a third party has never made a claim against your business and you do not know of any reason why someone may make a claim.*

I AgreeI Disagree
Do you currently have an insurance policy in effect for the coverage requested?*

YesNo

Business Details - Operations