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Entertainment – Foreign Production

Entertainment – Foreign Productionadmin2019-01-02T12:48:32-07:00

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Entertainment - Foreign Production

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
Any bankruptcy in the last 5 years?*
- 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:*
Does the production include any Stunts, Pyrotechnics, or Underwater Activities?*
- No
- Yes

Production Information
Title
Type of production*
Total Budget*
Production Start Date*
Date Format: MM slash DD slash YYYY
Production End Date*
Date Format: MM slash DD slash YYYY
Number of Episodes*
Country
State/Province*
Shooting Location
Synopsis*
Please provide a plot outline for your production.

Coverage Dates
Coverage Start Date*
Date Format: MM slash DD slash YYYY
Coverage End Date*
Date Format: MM slash DD slash YYYY
General Liability
General Liability
Waiver of Subrogation
- Exclude
- Include
Auto Liability
Hired & Non-Owned Auto Liability
Auto Physical Damage (25K/25K)
- Exclude
- Include
Employers Responsibility
Benefits for Voluntary Compensation-North Americans
Number of Employees from US and/or Canada*
Maximum Number of Employees Per Flight*
Inland Marine
Unscheduled Owned Equipment
Rented Equipment, Props, Sets & Wardrobes
Travel Accident
Guild 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.
Name
This field is for validation purposes and should be left unchanged.

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