Entertainment – Single Productionadmin2018-08-20T19:23:11-07:00 Entertainment - Single Production CUSTOMER INFORMATIONWhat type of entity is this insurance going to be for?*Choose OneCorporationIndividual or DBAL.L.C.Non-ProfitPartnershipOtherWhat 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 Please provide the first and last name(s) of the individual(s) who own the company/production.*Contact Person* First Last Phone*Email* Enter Email Confirm Email Any prior production insurance?*YesNoPlease provide the policy numbers, premiums and expiration dates of your prior insurance:*Any prior claims?*YesNoPlease provide the dates, amounts of the claim(s) and descriptions of what happened:*If you have had production insurance before, please provide loss runs for those policies, if you have them.If you have never had film production insurance before, it will help us provide you with more affordable coverage if you can provide a film producer's resume for the producer/executive producer of this project. Please upload a copy of that person's resume (web links will not suffice - this must be an actual resume showing at least two year's worth of film production experience). We are able to provide a quote without it, but we are able to submit to more underwriters, and potentially get you more affordable coverage, if we have a producer's resume. PRODUCTION INFORMATIONTitle of Production*Type of production*AnimationCommercialCorporate VideoDocumentaryEducational VideoFeature (for theatrical release)Feature (not for theatrical release)Music VideoOtherReality TV (Scripted)Reality TV (Unscripted)Short FilmTelevision PilotTelevision SeriesWhat kind of music is this?*What are the name(s) of the artist(s)?*Total Budget*Production Start Date* Date Format: MM slash DD slash YYYY Production End Date* Date Format: MM slash DD slash YYYY Provide the address of at least one shooting location* 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 Please provide a synopsis (plot outline) of the production*This needs to be a description of the types of scenes you will be shooting. Name of producer or executive producer* First Last The name and driver's license number of a producer is required by some of our carriers. If you do not want to provide the number we can add it later.Driver's License Number*Driver's License State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific QUALIFICATION QUESTIONSWill you be using DRONES during this production?*YesNoIf you will be shooting with drones, will your drone operator be FAA certified, have their own UAV (unmanned aerial vehicle) insurance and be willing/able to name you as additional insured on that policy?YesNoIf not, we can still offer coverage, it will just be significantly more expensive for us to do so.If you are using drones, please provide the following information about your drone usage: Dates you'll be using them, Synopsis of each scene you'll be shooting with drones, and whether the production will be responsible for operating the drone or if it will be hiring someone else to operate it.Any hard-core or soft-core pornography or live gangster rap music?*YesNoPlease provide details regarding the pornography or live gangster rap music.*Is there any filming that will be done outdoors?*YesNoAre there any production activities outside the U.S.?*YesNoPlease confirm your understanding that this policy only covers a single production*YesNoAre there any unprotected or open heights above 10 feet?*YesNoThis does not refer to open, outdoor spaces (i.e. the sky) - this refers to whether your actors will be performing on rooftops with unprotected edges, ledges of various structures (i.e. bridges), ladders or near the edge of cliffs/mountains.Please provide the details regarding the unprotected heights.*Any employees supplied to or from an employee leasing operation? (i.e. PEO)*YesNoWill the production include any stunts, pyrotechnics, aircraft, boats, water activities (in pools, lakes, rivers, oceans, etc.), race tracks, race courses, helicopters, motorbikes, snowmobiles, atv, blanks, squibs, guns or other hazardous activities?*YesNoConfirm no stunts, fight scenes or other hazardous activities*I confirm no stuntsThere are stuntsThis includes ANY pyro, choreographed fighting or anything else dangerous.Please provide details for the stunt activities, including dates and descriptions of scenes as well as safety precautions in place.*Are there any moving vehicles in the production?*YesNoWho will be operating the vehicle?*ActorStunt DriverWill there be any racing, speeding or skidding?*YesNoPlease provide a description of the scenes that will feature moving vehicles.*Will police be restricting access to the filming area while you're shooting the moving vehicle scenes?*YesNoIf not, how will you ensure that the general public (other vehicles/pedestrians) will be kept out of the filming area while you're shooting scenes with moving vehicles?*Will all traffic laws be obeyed while operating the moving vehicle?*YesNoWill any animals be used in the production?*YesNoWill an animal trainer be on set?*YesNoPlease provide details regarding the animals, including how many scenes, what type of animals are to be involved, date of animal scenes, etc.* COVERAGE OPTIONSDo you have any documents showing the coverage options that your policy needs to meet or exceed?*YesNoYou can upload your document so that when we quote this we can make sure that the policy we propose to you meets the requirements of your location/vendor/permit office etc.Please select your document to upload:Accepted file types: jpg, gif, pdf, xls, xlsx, doc, docx.General LiabilityExcluded$1,000,000/$1,000,000$1,000,000/$2,000,000$1,000,000/$3,000,000$2,000,000/$2,000,000$3,000,000/$3,000,000$4,000,000/$4,000,000$5,000,000/$5,000,000General Liability Medical Payment*Excluded$5,000This is the amount that the carrier will pay for liability medical injuries without legal action. Some carriers include this and others charge a fee for it.Do you need a Waiver of Subrogation?*YesNoThis is not common and costs additional premium. A WOS prevents the insurance company from going after the listed entity in the event that a claim is paid and it was actually their fault (such as the location caused someone to trip and fall and the insurance company paid out a claim prior to obtaining knowledge of who was to blame)Do you need to add a payroll service to your policy?*YesNoDo you need to add a city, county, state or other government entity to your policy?*YesNoDo you need Primary Wording?*YesNoThis is not common and usually increases the cost of the policy. Normally only required when a location or permit office require it.Excess Liability*Choose OneExcluded$1,000,000$2,000,000$3,000,000$4,000,000$5,000,000This is ADDITIONAL liability that goes on top of the general liability for higher limits. This is not normally required by most locations, vendors or permit officesAUTO COVERAGEHired and Non-Owned Auto Liability*Excluded$1,000,000$2,000,000$3,000,000$4,000,000$5,000,000This covers auto liability for any vehicle that is not owned by the Named Insured for bodily and property damage. This does not cover damage to the vehicle itself.Will you be renting or borrowing any vehicles during the producton?*YesNoIf yes, how much will it cost you to rent production vehicles?How much will it cost you to rent other types of vehicles?How many vehicles are you renting?*Please enter a number from 1 to 2000.What is the year, make and model of the vehicle(s) you will be renting?How much is the most expensive vehicle you plan to rent, worth?Please be as accurate as possible. Vehicles that are worth more than $100,000 need special consideration.How many days are you renting or borrowing vehicles?*Please enter a number from 1 to 2000.Will all drivers be at least 25 years of age and licensed to drive in the United States?YesNoWhat will the vehicles be used for?Will you be renting any 12-or-more passenger vehicles, or any buses/vans that will be used primarily to transport people?YesNoIf so, you will eventually need to provide the Name(s), Driver's License Number and the State the license was issued in for each person who will be responsible for driving the buses/vans. If you have this information now, please provide it to us by answering the third question down from this one.Will you need this policy to cover damage to rented/borrowed vehicles (if so, please request the hired and non-owned auto physical damage coverage below)YesNoHired and Non-Owned Auto Physical Damage*Excluded$125,000/$500,000$250,000/$500,000This covers the rented vehicles themselves. If you are renting a grip truck or other vehicle and need full coverage, this must be includedPlease provide the Name(s), Driver's License Number and the State the license was issued in for each person who will be responsible for driving the rented vehicles.We can provide a quote without this information, but it will be considerably more expensive. Please note that your drivers must have at least 3 years of violation-free driving in order to meet the underwriter's qualification standards.If you will have the vehicle overnight, where will it be kept?INLAND MARINE COVERAGERented EquipmentExcluded$10,000 or less$15,000$25,000$50,000$75,000$100,000$150,000$200,000$250,000$300,000$400,000$500,000$750,000$1,000,000OtherRented Equipment covers lights, cameras, lenses and other equipment used for production that is not a prop, set or wardrobe.Do you need the unlocked vehicle exclusion removed?*YesNoEquipment stolen from an unlocked vehicle is excluded by default. Based on the company, to remove this requires either an increase in premium or security information regarding the gear.Props/Sets/WardrobesExcluded$10,000 or less$15,000$25,000$50,000$75,000$100,000$150,000$200,000$250,000$300,000$400,000$500,000$750,000$1,000,000OtherPlease select the deductible for your equipment/props.*$500$1,000$2,500Please note that we will attempt to get you the deductible you request; however, the quote we offer will first and foremost reflect the most affordable option for coverage we can provide.Equipment Pick Up Date* Date Format: MM slash DD slash YYYY Equipment Drop Off Date* Date Format: MM slash DD slash YYYY Provide a description of the equipment you are renting*Will the equipment be stored overnight?*YesNoProvide a description of the security measures for keeping the equipment safe overnight*Will the insured be responsible for transporting the property?*YesNoHow will the equipment be transported?*Will the equipment be in protective cases?*YesNoWill the property stay in the possession of the insured at all times prior to returning to the rental company?*YesNoPlease explain why the equipment will not be in your possession prior to rental return*Negative Film, Faulty Stock and Digitized ImageExcludedIncludeThird Party Property DamageExcluded$250,000$500,000$1,000,000$2,000,000Third party property damage covers the location that you are filming at for damage to permanent aspects of the property.Extra ExpenseExcluded$10,000$25,000$50,000$100,000$250,000Extra Expense covers the additional cost in the event of a loss (i.e. your camera breaks and you have to rent a new one last minute)Office ContentsExcluded$10,000$25,000CAST & CREW COVERAGEWorker's Compensation*ExcludeIncludeWorker's compensation covers the cast and crew for injuries while working. It meets the state requirements for coverage if it is available in your state. You can also obtain this from a payroll service in most cases.To provide worker's compensation, please provide one of the following.*Tax ID NumberName and Social Security Number of an officer/ownerTax ID Number*Name of officer/owner.* First Last Social Security Number of officer/owner*What is the total payroll for all cast and crew?*How many shooting days do you have?*Accident/Medical Coverage*ExcludeInclude - $50,000 Per claim per personAccident/Medical provides reimbursement for medical treatment during the production. It is NOT worker's compensation and does NOT meet state requirements for Worker's Compensation insurance. This is simply a layer of protection for cast and crew for those not purchasing worker's compensation.How many cast/crew members do you need to cover?*Please enter a number from 1 to 2000.Will you be paying any of your cast or crew for work on this production?NoYesThis does not include deferred pay, volunteer work for film credit. Only if you are actually paying the cast and/or crew.Cast Coverage*ExcludeIncludeCast Coverage provides coverage in the event of death or illness to key cast personnel or animals. It compensates you for the additional expense required to replace the actor/animal.Cast Extra ExpenseExclude100% Of Production Budget75% Of Production Budget50% Of Production Budget25% Of Production BudgetCovered Person Extension (Without Sickness)ExcludeIncludeCovered Person Extension (With Sickness)ExcludeIncludeFamily BereavementExcludeIncludeAnimal Extra ExpenseExclude$10,000$20,000$30,000$40,000$50,000NameThis field is for validation purposes and should be left unchanged.