(Jumping Pillows, Jumping Pads, Bouncy Houses, Bouncy Slides, Bouncy Castles, Moonwalks)
GENERAL INFORMATION
INFLATABLES (Jumping Pillows, Bouncy Houses/Slides, Etc.)
CONCESSIONS (Food & Beverages)
Note: If Liquor Liability coverage is desired, please contact Kevin Morency for a quote. (Liquor Liability will only be available if we provide the General Liability for your agritainment operation.)
SEXUAL ABUSE (If located in Illinois, this section MUST be completed. If located in other states, complete only if you desire coverage.)
COMMERCIAL CRIME
PROPERTY INSURANCE
COMMERCIAL AUTOMOBILE INSURANCE
UMBRELLA AND WORKERS' COMPENSATION INSURANCE
SIGNATURE
The information I have provided is true and accurate to the best of my knowledge. I have not willfully concealed or misrepresented any material fact(s) or information. I understand completion of this questionnaire does not compel the company to provide coverage.
Questions? 877-244-9090Kevin Morency | kmorency@morencyinsurance.com Morency & Associates Inc.141 New Shackle Island Rd, Hendersonville, TN 37075Fax: 615-452-6580https://bouncyinsurance.com/