EVENT SUBCONTRACTORS

EVENT SUBCONTRACTORS

For AUDIO/VISIAL, & LIGHTING TECHNICIANS
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 company or entity (or individual name if not incorporated) you would like to insure.
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
Description of your operations:*
Annual Sales./Receipts:*
In Business Since:*
Do you have any ees who are currently CTS (certified technology specialists) certified?*

YesNo

Are you a member of the Event Safety Alliance (www.eventsafetyalliance.com)*

YesNo
Are you aware of the Event Safety Guide as published by the Event Safety Alliance?*

YesNo
Are you a member of any other industry trade association? If yes, please list:

	CTS	CTS-D	ATS-I
Nummber of Employees:

COVERAGE OPTIONS
GENERAL LIABILITY

General Liability covers payments the insured will become legally obligated to pay as a result of Bodily Injury or Property Damage arising out of an occurrence during live events, performances, etc. Applies to third parties, excluding your own cast and crew, location. Injury to your own cast and crew can be covered under workers compensation, if selected. If you would like a quote with workers compensation a separate application is be required.
Select General Liability Limit:*
Excess Liability Occurrence / Aggregate Limit:*
The excess liability is an additional layer of coverage above the general liability, auto, and employers liability.
AUTO
Hired & Non-Owned Auto Liability:*

IncludeExclude
Cost of Hire:*
Number of Loaned or Donated Vehicles:*
Number of days:*
Will any bus or van be hired for the purpose of transporting people?*

YesNo
Hired & Non-Owned Auto Physical Damage:*
INLAND MARINE
Electronic Data Processing Hardware & Software
(owned, leased and rented)
Electronic Data Processing Hardware & Software
Maximum per Item
Business Income/Extra Expense
Property in Transit and temporarily within other premises
Detrimental Code (Aggregate/Occurrence)
Terrorism

IncludeExclude
WORKERS' COMPENSATION
Workers Compensation Limits
Waiver of Subrogation

YesNo
Name of Payroll Company (if any):
Name of company officer excluded from coverage:
Total Estimated Payroll
Number of Employees

EQUIPMENT FEATURES

	Not Satisfied
Full Time
Part Time