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Performing Arts Application
Please enable JavaScript in your browser to complete this form.
-
Step
1
of 4
Client Code *As shown in email
*
Name
*
First
Last
Email
*
Phone
Property Information
Owner's Name
*
Any changes to any property insurance amounts you currently have?
Yes
No
Any additions or renovations to your property (ies) that has not been notified to us?
Yes
No
Do you rent your home for any party of the year
Yes
No
If yes, what is the time frame?
How many days, weeks, months
Source of Advertising
AirBnB
Homeaway
VRBO
Other
If seasonal property, do you have?
Caretaker
Home Watch Service
Automatic Delivery
Other
Other Seasonal
What year were the systems below updated?
Roof
HVAC
Plumbing
Electrical
Do you have a certificate for any central monitoring alarm station for Burglary or Fire?
Yes
No
Do you have any of these security features in your home? low temperature, water detection, permanent generator, Other ?
List popular carriers * disclose to send us a copy
Do you have any other property that we do not currently insure?
Yes
No
Please list addresses
Any properties titled or recently retitled under a trust or LLC?
Yes
No
Do you conduct any business operations from your home?
Yes
No
Describe home business operations
What type of fuel is used to heat your home
Gas
Electric
Oil
Other
Other fuel source
Next
Vehicle Information
Have you purchased, leased, sold or disposed of any motorized vehicles insured by us?
Yes
No
Which vehicle?
How many licensed drivers have regular use to your vehicle?
Do you use any of your auto (s) for business/income producing purposes?
Yes
No
Other
Would you consider a proposal to increase your Auto Liability and/or Uninsured limits?
Yes
No
Any additional licensed drivers in your household that have not been reported to us?
Previous
Next
Collections
Any additions to jewelry, silver, furs, collectibles, fine arts, or antique cars?
Jewelry
Silver
Furs
Fine Arts
Collectibles
Other
Miscellaneous
Do you own, lease, or rent a dock?
Yes
No
Do you have any children away at school?
Yes
No
Do you own a drone?
Yes
No
Excess Umbrella Liability
Have you purchased, leased, or disposed of any motorized vehicles insured by us?
Yes
No
Watercraft…aircraft…ATV,golf cart, snowmobile, motorhome…etc
Do you sit on any nonprofit boards?
Yes
No
Do you employ domestic staff?
Yes
No
Previous
Next
Do you have any specific questions or comments regarding your existing policy that you would like us to address prior to renewal?
Additional coverages may be available to provide broader protection. Please select any items below that you would like more information on:
Flood
Life
Disability
Sewer Back Up
Umbrella / Excess Liability
Earthquake
Message
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Claims
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