Vendor

TYPES OF “VENDOR” CLASSIFICATIONS:

  • Food Cart Operator
  • Caterer Service
  • Bartending Service
  • Performer (i.e. small band, dance group, costumed child character, etc.)
  • Merchandise Table
  • Information Booth

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SCROLL DOWN TO FILL OUT OUR ONLINE APPLICATION


Name and Address
Name and Address
Name and Address
EVENT INFORMATION
* Include setup and teardown dates
FOR ANNUAL COVERAGE ONLY: Number of events to be attended annually. “Event” can be considered as a festival, conference, sporting event, private party etc. An estimated range for number of events to be attended is acceptable for quoting.
FOR ANNUAL COVERAGE ONLY
PAST INFORMATION
Has this event been held before?
Have you had General Liability coverage as a Vendor before?
Have you ever had a General Liability claim as a Vendor?
Has any insurance carrier cancelled or refused coverage?
LIABILITY INFORMATION
Please note that our standard limits of liability are $1,000,000 occurrence and $2,000,000 aggregate. Most venues/cities/locations require this minimal amount of coverage. We do not offer policies less than $1,000,000 in occurence limit.
Please note we have the ability to raise the limits of liability over $1,000,000 occurrence—some venues/cities/locations require this. Selecting Excess General Liability is not advised unless a venue/city/location is requesting higher limits as this will increase the total premium. If you have questions about this, please contact our office.
Require Non-Owned/Hired Automobile coverage?
Require Abuse/Molestation coverage?
AFFIRMATION AND SIGNATURE
Fraud statement *
Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance or statement of claim 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 shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.
Warranty statement *
I hereby warrant and confirm that the above information, to the best of my knowledge, is true and correct, and further certify that I have read all of the questions and answers on this application. I understand this application is a requirement for coverage, a part of the contract and evidence of my acceptance of this insurance, and any falsification or misrepresentation will be deemed a breach of contract, voiding all insurance coverage. It is understood and agreed that the completion of this application shall not be binding either to the proposed insured or the company until accepted by the company or companies in writing.
BROKER INFORMATION