Free Quote: Equipment & Production Insurance

CONTACT INFO
First Name*
Last Name*
Phone*
Email*
Producer Name*
Producer Driver's License #*
BUSINESS INFO
First Name*
Last Name*
Production Company*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Website*
PRODUCTION INFO
Title of Production*
Budget*
Shoot Dates*
Tell us the state/s where you are filming:*
Brief Synopsis*
COVERAGE INFO
What insurance do you require?*
- General Liability
- Rented Equipment
- Hired Auto Liability
- Hired Auto Comp & Collision
- Workers Compensation
- Umbrella Liability
RENTAL INFO
How many places are you renting from?*
Total $ value of all the equipment:
Date to pick up equipment*
MM slash DD slash YYYY
Date to drop off equipment*
MM slash DD slash YYYY
Any special requirements or permits?*
MISCELLANEOUS INFO
By entering your name in the “YOUR SIGNATURE" field below, you will be confirming that this Production does not include any of the following: Stunts, Fight Scenes, Guns, Pyrotechnics, Pornography, Live “Gangster Rap” Music, Filming outside the USA, Filming from above 15 Feet. You will also be confirming that you understand that this insurance will only be for this specific production.
YOUR SIGNATURE (Enter your name here)*
Phone
This field is for validation purposes and should be left unchanged.

CONTACT INFO