Entertainment – Movie Boatadmin2019-01-02T12:47:08+00:00Get started by filling out this form and someone from our team will contact you shortly!Entertainment - Movie BoatWhat is the name the insurance will be under?*This would be the LLC or Individual that you are using for any contracts, permits etc.What type of entity is this?*IndividualLLCLLPCorporationNon-ProfitAddress*Please note that in order to offer a policy you have to have a U.S. address. We cannot insure a foreign entity that does not have a U.S. base of operations. Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contact Person* First Last Phone*Email* Enter Email Confirm Email Any insurance declined or cancelled in the past 3 years?NoYesAny prior Movie Boat insurance policies?NoYesPlease provide policy numbers, expiration date, carrier and premium of prior policies.*Will the production include any Stunts, Water-Skiing or over-the-side activities?NoYesProduction Title*Type of production*i.e. commercial, feature film (theatrical), feature film (non-theatrical), educational, documentary etc.Production Start Date* Production End Date* Gross Production Cost*The total budget for the production. If filming on and off a boat only use the portion of the budget that includes the boat operations.How many episodes are there?*If this is a feature, commercial etc. just enter 1.Please enter a number from 1 to 50.Please provide at one location where filming will occurIf you don't have an exact address use the specific harbor or other type of location where the boat will be. City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Please provide a short synopsis of the production*Name of producer/executive producer/director* First Last What is their title?*Executive ProducerProducerDirectorDriver's License Number*Driver's License StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificVessel Name*Year Built*Manufacturer/Builder*Vessel Type*Vessel Length*Vessel Registration Number*Market Value*Vessel Owner's Name* First Last Vessel Owner's Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Vessel UseTotal days using vessel at sea*Operating use is when the vessel is not stationed at the dock.Please enter a number from 1 to 90.Number of Vessel Crew*Please enter a number from 1 to 50.Number of Film Crew, Actors & Volunteers*Please enter a number from 1 to 50.Is your company operating the vessel?*YesNo (a 3rd Party is operating the vessel)Total days using vessel at dock*Operating use is when the vessel is stationed at a dock.Please enter a number from 1 to 90.Number of Vessel Crew*Please enter a number from 1 to 50.Number of Film Crew, Actors & Volunteers*Please enter a number from 1 to 50.Describe how the vessel will be used in the production*Place of attachment*Will the vessel be used within 50 miles of attachment?*NoYesNavigation Area*The Navigation area is the territory through which the vessel travels.Coverage Start Date* Coverage End Date* Hull & MachineryExcludedIncludeCollision Tower's LiabilityExcludedIncludePrimary Collision Liability (Running Down Clause)ExcludedIncludePollutionExcludedIncludeWharfinger's LiabilityExcludedIncludeExcess LiabilityExcluded$4,000,000$9,000,000Inland Marine Coverage OptionsOwned Equipment, Props, Sets, WardrobeExcluded$50,000$75,000$100,000$150,000$200,000$250,000$350,000$500,000Rented Equipment, Props, Sets, WardrobeExcluded$50,000$75,000$100,000$150,000$200,000$250,000$350,000$500,000Negative Film & Faulty StockExcluded$25,000NameThis field is for validation purposes and should be left unchanged.
