Client Details

Please answer all questions to prevent a delay in processing your quote request.

All Fields with * are Required.

Special Event Information

When do you need the quote? :

I am / We are an:

Name of Entity Type

Type of Event :

Event Name:

Describe Event In Detail:
(must exceed 10 words)

Special Events Date

Event will be held on:

Month: Day: Year :

Number of days the event will last:

How many events in next 12 months?

Contact Information

Contact Name:

*
(first)

*
(last)

Address:

(street)

*
(City)

*
(zip)

Phone:

Fax:

Email:

Alternate Email:

Other Phone:

Special Event Coverage

Need Coverage For :

Will there be any Live Music at the Event?

Yes No

Will alcohol be served at the event?

Yes No

Have you bought Insurance from us Before?

Yes No

Entire Budget for This Event:

Cost of Admission in dollars:

Total Attendees:

Daily Participants:

Venue Details (Location Where Event Will take Place)

Venue City:

Will the Event be held?

Indoor Outdoor Partially Outdoor

Vendors/Exhibitors needed to be covered under your policy?

Yes No

Number of Exhibitors:

Number of Vendors:

Enter the Security Text