Event Liability Application

Client Information

Organization Information
Contact Information

Event Details

Event Dates
Activities

Certain activities may make your event ineligible for coverage and/or may result in additional terms, conditions or exclusions being applied. Please check any and all of the following activities that apply to your event:

Other Details
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Coverages

General Liability
What is covered?
Covers the insured for losses due to bodily injury or property damage caused by the insured's employees or agents. Locations and vendors will require general liability for 1,000,000
Please note, if the insured is not either serving or selling the liquor, additional liquor coverage is not required.
What is covered?
Liquor liability provides covers the following losses for which you may be held liable for: 1) causing or contributing to the intoxication of a person, 2) The accidental furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol, or 3) Any statute, ordinance, or regulation relating to the sale, gift, distribution, or use of alcoholic beverages.
Property
What is covered?
Camera, sound, lighting and miscellaneous rented equipment. Owned equipment is not covered. Props, sets, and wardrobe are covered.
Automobile
What is covered?
Liability for vehicles rented or borrowed for the event. Liability covers injury to third parties or damage to their property.
Waiver of Subrogation
What is covered?
The named insured's intentional relinquishing of any right to recover damages from another party who may be responsible.

Additional Insureds

Fraud Statement

Signing this application does not bind the Applicant or the Company to complete the insurance, but it is understood and agreed that the information contained herein shall be the basis of the contract should a policy be issued. If any of the above questions have been answered fraudulently or in such a way as to conceal or misrepresent any material fact or circumstance concerning this insurance or the subject thereof, the entire policy shall be void.
I/We have read the above and agree that to the best of my/our knowledge and belief same fully represents the true statement of facts.

Applicant