Affordable Recreational Insurance - Best Coverage in Westchester, IL

Performing Arts Type

Theatre
Music
Dance
Other

Name of Organization*

Address

Street Address City State ZIP Code

Web Page

Contact Name*

Phone#*

Email*

Fax#

Type of Business Entity

Corporation
NFP
Individual
Other

Federal ID#

State ID#

Years in Business

Are you a traveling Performing Arts Group?

Yes
No

Do you need a Short Run or Annual Coverage quote?

ShortRun
Annual

Venue Name

Address

Street Address Address Line 2 City State ZIP Code

# of Seats

Avg. Ticket Price

Est. Total # Attendance:

Number of Performers:

Performance Start Date

Performance End Date

Estimated Annual Payroll (including independent contractors)

# Total Performances per run

# Total Performances per Year

Estimated annual revenue from Performances

Do you have a permanent home?

Yes
No

What is your annual estimated total Admissions (# of tickets sold)

Do you hold classes/workshops?

Yes
No

If Yes, describe location(s) & approximate square footage of each

Do you ever serve liquor?

Yes
No

Do you ever sell liquor?

Yes
No

If Yes, at how many events per year?

Do you have a Board of Directors?

Yes
No

If Yes, # of Members?

Special Considerations or Questions?

Name of Organization

Print Your Name & Title

Signature

Date

Reference to Common Types of Insurance Needed by Performing Arts Groups/ Please Quote the Following:

General Liability: Many venues now require a Certificate of Insurance as part of the requirements to rent a space. The certificate covers against claims arising out of bodily injury to the patrons and limited property coverage to third party claims. This policy alone DOES NOT cover injury to your employees, participants, volunteers, students, or company members. It also, alone, DOES NOT cover property owned, leased, rented or borrowed by your group.
Property: This coverage will reimburse you for losses to business assets/property. There are 4 different categories to derive, each with its own dollar figure or value. The categories are: 1. Owned 2. Owned by Others (and in your organization's Care, Custody & Control) 3. Rented or Leased to your organization 4. Travels with your organization ("Inland Marine") (The typical property deductible is $1,000 per occurrence, so it may not be cost effective to insure your property if it is valued at under $10,000)
Accident Policy: Many groups have no employees, but still feel an obligation to assist participants, volunteers or students when an injury may occur. We provide an accident policy for groups that pays medical expenses on an excess basis with no deductibles. Over 90% of our accident policies written last year were for the minimum premium. The average premium was $375.
Workers Comp: According to state law, if you have 2 or more individuals what you are paying as employees, you MUST carry workers compensation coverage. The basis of the premium is on payroll and job classification. To obtain a quote, we need annual payrolls, job classifications and your FEIN.
Directors & Officers: Insures your Directors and Key Officers if they are personally named in a claim or lawsuit stemming from their activities with your organization. An additional application and current financial statements are required.

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