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Camps & Sporting Events
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Vendors & Exhibitors
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Short Term Film Application
Short Term Film Application
SHORT TERM FILM APPLICATION
1
General Information
2
Coverage Information
Contact Information
Insureds' Name:
First
Last
Insureds' Address:
Street Address
City
State / Province / Region
ZIP / Postal Code
Contact Name:
First
Last
Contact Email:
Contact Phone #:
Drivers' License #:
Federal ID #:
Production Details
Production Title:
Production Type (Short Film, Documentary, etc):
Total Production Cost/Budget:
Synopsis:
Shoot Location(s):
Eligibility Questions
Does the production include any of the following (check all that apply)?
Stunts
Pyrotechnics
Aircraft
Drones or UAV's
Boats
Animals
Race Tracks
Race Courses
Helicopters
Motorbikes
Snowmobiles
Blanks
Squibs
Guns
Rap Music
Please provide details:
Are there any unprotected or open heights above 15ft?
Yes
No
Please provide details:
Is insurance coverage required outside of the United States or Canada?
Yes
No
Please provide details:
Have there been any prior production insurance losses of any kind declared by the insured?
Yes
No
Please provide details:
Coverages
Rented Equipment Limit (if any):
Props, Sets, Wardrove Limit (if any):
Faulty Stock & Negative Film Limit:
None
$25,000
Third Party Property Liability Limit:
None
$250,000
$500,000
$1,000,000
Extra Expense Limit:
None
$10,000
$25,000
$1,000,000
General Liability Limit:
None
$1,000,000 Occurrence / $1,000,000 Aggregate
$1,000,000 Occurrence / $2,000,000 Aggregate
Liability Umbrella Limit:
None
$1,000,000
$2,000,000
$3,000,000
Coverage Dates & Additional Insured
Coverage End Date:
MM slash DD slash YYYY
Coverage Start Date:
MM slash DD slash YYYY
Date Rented Equipment will be Returned:
MM slash DD slash YYYY
Additional Insured:
Additional Insured Address:
Street Address
City
State / Province / Region
ZIP / Postal Code
Additional Insured:
Additional Insured Address:
Street Address
City
State / Province / Region
ZIP / Postal Code
Questions?
We’re here to help! Contact us today!
CONTACT US
Email Us
events@eventinsurancenow.com
Call Us
877.305.5040
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