Venue Insurance Program — Set-Up Form

Venue

Venue name *

Street address *

City *

State *

ZIP *

Type of venue *

Years venue has operated

Venue website

Contact

Company contact name *

Phone *

Email *

Events & policy

Requested policy term

Agent or venue admin fee (per event, if any)

Types of events hosted at this venue *

Hosted events — previous year

Hosted events — planned this year

Claims history

Has the venue or any tenant user filed liability claims in the past 5 years? *

noyes

Insurance limits

Each occurrence limit

General aggregate limit

Additional insureds & certificates

Additional insureds to be added (name & address — one per line)

Email addresses that should receive certificate of insurance copies

Anything else?

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Set up your venue's insurance program