Equipment Floater Application:

Contact Information
  • Name of Insured                        
  • Entity Type                                 
  • Street Address                            
  • City                                            
  • State                                           Zip
  • Contact Person                          
  • Phone                                        
  • Fax                                          
  • Email                                          

Qualification Questions
Any equipment losses in the past 5 years? Yes No
Principally involved in pornography production? Yes No
Any coverage cancelled or denied in the past 3 years? Yes No
Are you primarily in the business of renting equipment to others? Yes No

 
Additional Information
Years of Industry Experience

Description of Business Operations

Address of primary location
(if different than mailing address above)


If scheduled equipment is over $100,000, provide name of central station alarm company at primary location

Prior Coverage
Carrier Name Policy Number Expiration Date

 
Coverage Options

Effective Date of Coverage

Category

Scheduled Equipment Limit to Insure
  • Editing / Post Production Equipment
  • Recording / Studio Equipment
  • Sound / Location Recording Equipment
  • Musical Instruments / Band Equipment
  • Camera / Production Equipment
  • PA / Sound Reinforcement Equipment
  • Office Contents
  • Theatrical Equipment

 
Unscheduled Equipment

Rented Equipment
Unscheduled Equipment ($10,000 maximum)
Rental Reimbursement (Daily limit)
$500 $1,000
$1,500 $2,000
$2,500

Authorized Agent: Date

         

© Sihle Entertainment Insurance, Inc.