Event Date / Location(s)
Date(s) of your event:
Event Location (Address):
City:	State:   Zip:
Will there be other locations?:	Yes   No (If "yes", list additional locations in comments section below.)

Event Information
How many people will attend event?:
Will admission be charged?:	Yes   No
If Yes, how much per person?:	$
Charges other than admission?:	Yes   No
If "yes", How Much for:	Food: $ Drink: $ Merchandise: $
Estimated total gross income from all event-related charges:	$
Will alcohol be served?: If "yes", served by:	Yes   No Your Employees     Volunteers     Other
Will Security Personnel be Present?: If "yes" will they be:	Yes   No Your Employees     Volunteers     Security Firm
Will you have fireworks?	Yes   No
Will there be games or rides?: If "yes", what kind:	Yes   No
Please describe any entertainment, special exhibitions, organized sporting events, or competition that will take place at event:
Will transportation or lodging be provided?:	Yes   No
Are you required to name additional insureds on this insurance?:	Yes   No

Additional Comments

Please give any additional comments you feel appropriate for this quotation. If you have additional information where there was not enough fields above, such as additional event location addresses, etc..., please enter them here.

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