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408-286-1111 ext 106
408-997-7890
CA Lic#
0697055
 

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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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California Lic # 0697055
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