Entertainment – Foreign ProductionEmet Digital2019-01-02T12:48:32-08:00 Get started by filling out this form and someone from our team will contact you shortly! Entertainment - Foreign Production Customer InformationWhat type of entity is this insurance going to be for?*Choose OneCorporationIndividual or DBAL.L.C.Non-ProfitPartnershipWhat 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 AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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 Production InformationTitle Type of production*AnimationCommercialCorporate VideoDocumentaryEducational VideoFeature (for theatrical release)Feature (not for theatrical release)Music VideoOtherReality TV (Scripted)Reality TV (Unscripted)Short FilmTelevision PilotTelevision/Web SeriesPlease explain your "other" designation:* Total Budget* Production Start Date* MM slash DD slash YYYY Production End Date* MM slash DD slash YYYY Country*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweState/Province* Synopsis*Please provide a plot outline for your production. Coverage DatesCoverage Start Date* MM slash DD slash YYYY Coverage End Date* MM slash DD slash YYYY General LiabilityGeneral Liability1M/2M2M/2M3M/3M4M/4M5M/5MWaiver of Subrogation Exclude Include Auto LiabilityHired & Non-Owned Auto LiabilityExcluded1M2M3M4M5MAuto Physical Damage (25K/25K) Exclude Include Employers ResponsibilityBenefits for Voluntary Compensation-North AmericansExcluded1M2M3M4M5MNumber of Employees from US and/or Canada*Maximum Number of Employees Per Flight*Excluded12345Inland MarineUnscheduled Owned EquipmentExcluded50k75k100k150k200k250kRented Equipment, Props, Sets & WardrobesExcluded50K75K100K150K200K250KTravel AccidentGuild Members, Non-Guild Members, Aggregate Limit*Guild refers to employees that are part of a Guild, Trade Association or Labor Union. Non-Guild refers to all other employees.Excluded1M Guild / 50K Non-Guild / 10M Aggregate1M Guild / 100K Non-Guild / 10M Aggregate1M Guild / 250K Non-Guild / 10M Aggregate1M Guild / 500K Non-Guild / 10M AggregateNumber of people to be covered by the Travel Accident Policy?*Volunteer AccidentAggregate Limit of Liability*This would provide coverage for accidents involving unpaid volunteers. Excluded $250,000 NameThis field is for validation purposes and should be left unchanged.
