Special Events Insurance

In a Rush, Complete this questionnaire and call us at 408-286-1111 ext 106

Obama care

info@g1g.net

408-286-1111 ext 106

408-997-7890

CA Lic#

0697055

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CEO Zain Jeewanjee
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Client Details

Please answer all questions to prevent a delay in processing your quote request.

All Fields with * are Required.

Special Event Information

When do you need the quote? :

Contact Name:

I am / We are a:

Name of Entity Type

What type of Event are you Holding ( example Wedding / Birthday party / Trade Show / Vendor ) :

What is the Title or Name of this Event:

Please describe in detail the event, be specific, Who, Why, What will this event consist of ? will you have Vendors ?:

Special Events Date

Date this event will start:

Time this event will start:

Time this event will Ends:

Number of days the event will last:

How many such events do you expect to attend / hold in the next 12 months ?

Contact Information

Address:

*

*
*	*
*

Email:

Alternate Email:

Phone Number:

() *

Secondary Phone Number:

()

Fax:

()


Special Event Coverage

Need Coverage For :

Will there be any Live Music at the Event?

Yes No

Will you provide any Security?

Yes No

Will alcohol be served at the event?

Yes No

Have you bought Insurance from us Before?

Yes No

Cost of admission per attendee:

Total attendees or spectators:

Daily Particapants / Oraganizers:

Venue Details (Location Where Event Will take Place)

Venue Name:

Address:

Will the Event be held?

Indoor Outdoor Partially Outdoor

Vendors/Exhibitors needed to be covered under your policy?
Number of Exhibitors:

Yes No

Number of Vendors:

How Did You Find Us:

Enter the Security Text

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