SPECIAL EVENTS QUESTIONNAIRE For General Liability, Excess Liability, Property, Liquor Liability, Participant Accident, Rental Equipment , Event Cancellation, Hired Non-own Auto Please, fill out the form completely If you have received a quote from us before, please provide quote number: (usually 5 to 9 digits) Contact Name: Contact Phone: Organization or Person Taking out Insurance Name: Mailing Address: (including full address and zip code, No PO BOX) Phone: Fax: Email: Name of Venue: Location of Event: (include full address and zip code, No PO BOX) Name of Party requiring a Certificate of Insurance: (include full address and zip code, No PO BOX) Title/Name of Event: Date(s) of Event: Daily Attendance at Event: Type of Event: (i.e. Class Reunion, award dinner, parade, dance, trade show, retreats) Other important information we should know: Submit for Quote

 

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