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PLEASE DO NOT USE THIS FORM FOR NEW ACCOUNT SUBMISSION, PLEASE REFER TO THE SPECIAL
EVENT APPLICATION. THIS FORM IS TO DECLARE AN EVENT ONLY ON AN EXISTING POLICY AND
MAY REQUIRE APPROVAL FROM THE INSURANCE COMPANY UNDERWRITER.
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Welcome to
Declared Event EZ-Quote from Entertainment Pro Insurance.
For fast service on your commercial
accounts complete the form below and hit the “Step Two†button. Your submission
will be electronically delivered to the next available Commercial Lines Underwriter.
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BASIC INFORMATION
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Client Name :
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Company Name is required!
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Date Declared:
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Date Declared is required!
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Date of Event:
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Date of Event is required!
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Load In & Load Out Dates:
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Load In & Out Dates is required!
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Type of Event:
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Type of Event is required!
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Name of Event:
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Name of Event is required!
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Your Duties at this Event:
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Your Duties is required!
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Contact Person:
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Contact Person is required!
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Phone:
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Phone is required!
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E-mail Address:
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Email address is required!
Please enter a valid e-mail address!
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ADDITIONAL QUESTIONS
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ADDITIONAL COVERAGES
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Rented Equipment Limit ($5,000 minimum
- $2,000,000 maximum): $
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Dates rented equipment will be in delivered
and returned
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1a.
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Will rented portable equipment (i.e. lighting, sound, video, portable toilets, generators, forklifts, etc.)
Will rented portable equipment - is required!
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Dollar replacement value required (you may have to ask the rental company for the values):
$
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1b.
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Will rented Furniture be used (i.e. dining tables, any kind of chairs, sofas, coffee tables, end tables, etc.):
Will rented Furniture be used - is required!
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Dollar replacement value required (you may have to ask the rental company for the values):
$
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1c.
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Will rented Fixtures be used (i.e. awnings, tents, etc.):
Will rented Furniture be used - is required!
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Dollar replacement value required (you may have to ask the rental company for the values):
$
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1d.
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Will rented Growing Plants be used (i.e. ficus trees /bushes, other types of potted plants be used as barriers or decoration):
Will rented Furniture be used - is required!
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Dollar replacement value required (you may have to ask the rental company for the values):
$
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2.
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Will the property be stored overnight?
Property Stored Overnight question - is required!
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If Yes, please provide details on how it will be stored:
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3.
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Will you be responsible for transporting the property?
Insured Responsible for Transporting question - is required!
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4.
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Will the property stay in your possession at all times prior to returning
to rental company? Will it be secure?
Will Property Stay in Possession of the Insured question - is required!
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Please explain:
If Not in Possession explanation - is required!
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ATTACH COPY OF VENUE CONTRACT
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(You will get a summary page
to review before submitting)
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