Express Short Term Production Application

Express Short Term Production Application

This express application is not for all available coverages. It is for rented equipment, general liability, location damage if selected. If you need a policy to include workers compensation or additional coverages please fill out the Full Production Application.
For Feature Films, Documentaries, Short Films, Music Videos, Commercials, Etc.

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 your individual name you would like to insure. Use the same name as on your rental quote, location agreement, etc.
Entity Type*
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
E-mail*

Confirmation Email
Website

PRODUCTION DETAILS
Project Title*
Project Synopsis*
2-3 sentences describing your film's story.
Type of Production*
Artist Name*
Genre of Music*
Brief description of the music video:*
Total Gross Production Budget*
Total production expenses incurred during the dates requested below.

Planned Filming Locations: (One Per State)*

Coverage Start Date*

MonthDayYear
Begin coverage on the date you pickup equipment, rent locations, etc.
Coverage End Date*

MonthDayYear
Insurance exp. is 12:01am. If your last day or filming is April 25th use April 26th as the last day of coverage (as it will expire on 04.26 12:01am). Please include equipment return date.
Are you renting equipment?*

YesNo
Equipment Pickup Date*

MonthDayYear
Date
Equipment Drop Off Date*

MonthDayYear
Date

INLAND MARINE

Property Coverage such as rented camera equipment etc.
Rented Equipment Limit*
(total replacement cost value)
How will rented equipment be secured overnight?*
Will the rented equipment stay with you at all times?*

YesNo
If no, please explain.
Will the equipment be transported in protective cases?*

YesNo
If no, please explain.
Is Third Party Property Damage Required? How much?
(Damage to rented premises such as a shooting location). Not the same as General Liability.
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 filming your scheduled activities. 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.
General Liability Limit*
Occurrence/Aggregate. Film permit offices, locations typically require the $1M liability limit.
Excess / Umbrella General Liability Limit
Select only if higher limits are required. Film permit offices, locations typically require the standard $1M liability limit.

Additional Information, Comments
Additional Information or Comments, if necessary, can be provided.
Would you like to receive a complimentary Errors and Omissions quote for your completed film?

YesNo
Would you like to receive our quarterly newsletter?*

YesNo
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UNDERWRITING QUALIFICATION