Special Events Application

  • General Information

  • (as it should appear on the policy)
  • (additional names under which the business operates)
  • Event Specific Information

  • 1. Will the event have or feature any of the following activites:
  • **Music or entertainment incidental to the event is ok
  • If there is a musical performer, please indicate the type of music to be provided/performed:
  • Event Details

  • (average daily attendance X no. of days)
  • Start DateEnd Date 
    Add a new row
    (including set up and tear down)
  • Start DateEnd Date 
    Add a new row
  • Start am/pmEnd am/pm 
    Add a new row
    (including set up and tear down)
  • Location Of Event

  • Alcoholic Beverages

    (e.g.: individual drinks are offered for sale for cash or with pre-purchased tickets).
    (e.g.: providing wine and beer for free, but also having a cash bar)
  • Liquor Liability Coverage

    Complete this section only if selecting this optional coverage.
    Indicate all that apply
  • Additional Insured Requests

    Complete this section to request additional Insureds on the policy.