• Movie Boat Application


  • APPLICANT INFORMATION

     

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  • UNDERWRITING QUALIFICATION

  • Insurance History

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  • PRODUCTION DETAILS

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    Pick a Date
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    Pick a Date
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    Pick a Date
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    Pick a Date
  • Production Personel

  • HULL & MARINE LIABILITIES

  • INLAND MARINE

    Property Coverage such as rented camera equipment etc.
  • VESSEL DETAILS & COVERAGE

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  • Additional Information, Comments

  • Terms and Conditions


    Please carefully review the Terms and Conditions below:

    • I represent that this application form has been completed after proper inquiry and, based on this inquiry, I represent the application contents are true, accurate, and not misleading.
    • I represent that I understand and agree that if any of the contents of this application are intentionally untrue, inaccurate, or misleading, in any material respect, or if I fail to notify the insurance company of additional information that might render the contents of this application untrue, inaccurate, or misleading, in any material respect, then the insurance company is entitled to rescind any policy issued pursuant to this application.
    • Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and civil penalties.  Please click the link below for individual state notices.
    • I represent that I understand and agree that this application and all materials submitted in connection with this application are incorporated into and form the basis of any policy issued by the insurance companypursuant to this application.
    • I represent that by signing this application I am representing that I am duly authorized to execute insurance contracts on behalf of the entity applying for this coverage and that all representations (whether verbal or written) made in connection with this application are made on behalf of and shall be fully binding upon such entity.
    • A quotation received is not binding on the Insurer in any way. 
    • By clicking 'Submit Application' you are not agreeing to purchase coverage.  If terms can be offered you will receive a free, no-obligation insurance quotation via email.  All quotes require underwriter’s approval and payment prior to binding.  Please read all exclusions indicated on the quotation.
    • Please note that once coverage is bound, the policy cannot be cancelled.
    • The insurance quotation will be based solely on the coverages and limits selected on this application.
    • Please ask your Film Emporium, Inc. representative to further explain coverage details, exclusions (including stunts and/or other hazardous activities), limits or other provisions of any insurance policy, or to request a sample policy form.
       

    By submitting this application you indicate that you have read and accepted the Terms and Conditions above.

     

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