Entertainment - Foreign Production - Frankel & Associates

Customer Information

What type of entity is this insurance going to be for?*

What is the name that the insurance will be under?*

If you do not have a company, the name on the policy needs to match the name you are using for your vendors, permit offices or any other contracts that you have.

Address (No PO Boxes)*

Street Address City State ZIP Code

Contact Person*

First Last

Phone*

Email*

Enter Email Confirm Email

Any prior insurance?*

Yes
No

Please provide the policy numbers, premiums and expiration dates of your prior insurance:*

Any prior claims?*

Yes
No

Please provide the dates, amounts of the claim(s) and descriptions of what happened:*

Are there any planned activities involving any of the following special hazards: Stunts, Pyrotechnics, Use of Aircraft, Interaction with Wild Animals, Operation or Control of Watercraft?*

No
Yes

Will there be any filming whereby you will have control over the use of public roadways?*

Yes
No

Any bankruptcies in the last 5 years?*

Yes
No

(800) 696-3023

[email protected]

Forms

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Entertainment - Foreign Production

Customer Information

Production Information

Coverage Dates

General Liability

Auto Liability

Employers Responsibility

Inland Marine

Travel Accident

Volunteer Accident