Commercial Lines – Vendor/Exhibitor Applicationadmin2018-08-20T19:47:30+00:00 Commercial - Vendor/Exhibitor Application 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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Person* First Last Phone*Email* Enter Email Confirm Email Any prior claims?*YesNoPlease provide the dates, amounts of the claim(s) and descriptions of what happened:* Event InformationPlease choose the best fit for your vendor/exhibitor activities:*Vendor Sales: Food & Beverage (with alcohol)Vendor Sales: Food & Beverage (no alcohol)Vendor Sales: Clothing, CD/DVD, Electronics, etc.Exhibitor: Brochures and Product Information (no sales)OtherWhat date do you want this policy to start?* What date do you want this policy to expire?* What is the name of the event that you are attending?*What is the address for the event?* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you need primary wording?*YesNoPrimary wording would be requested by the location or promoter putting on the event under the insurance section of the contract. It is not very common and it costs additional to include.Do you need a waiver of subrogation?*YesNoA waiver of subrogation would be also be requested by the location or promoter putting on the event under the insurance section of the contract. It is not very common and it costs additional to include.What liability limits do you require?*1M/1M1M/2M2M/3M3M/4M4M/5MPlease let us know of any other insurance requirements that you have.If you have the insurance requirements, please upload them so that we can provide you with an accurate quote.Accepted file types: jpg, gif, png, pdf, xls, xlsx, doc, docx, tiff.
