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Quote Request (Income Stabilization Insurance)

Contact Information **Please note that there is a $1,000 minimum premium amount applicable to all policies**

* Required Fields
Name:*
Company:*

Address:*
City:
 State:
 ZIP:

Phone:*
Fax:*
Email:*

Insurance Broker:
Yes | No
If (Yes), Name of Agency:


Event Information

Event Name:
Event Location:
City:
State:
 ZIP:
Event Type:
Web-Address:

Total Amount of Coverage Requested $

Previous Weather Insurance:
a) Has this event been insured before?
Yes | No
b) If Yes, with which Insurance Carrier?:


Coverage Information

Date(s) of Event
Hours of Coverage
Limit Per Day
TO
$
TO
$
TO
$
TO
$

Please select the weather peril(s) desired:
a) Cumulative Rainfall Coverage (in inches):

1/100 (.01)

1/10 (.10)

2/10 (.20)

1/4 (.25)

1/3 (.33)

1/2 (.50)

3/4 (.75)
b) Rain Free Hours

“X” hrs out of

“Y” hrs:
OR

Non-Consecutive Dry Hrs:
OR

Consecutive Dry Hrs
c) Snow Coverage:
Cumulative Snow Fall over a 24 hr period:
4"
5"
6"
8"
 10" Other
d) Wind Coverage: (maximum/minimum/average)
e) Temperature: (maximum/minimum/average)
Claim Settlement:
Closest Hourly National Weather Station to the Event Location(s):
OR
Independent Weather Observer on- or off-Location:

Protecting Your Events

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