**In the event of a forecasted weather event, Clarion may have an early closure and/or a delayed opening for the safety of our office staff. Customer requests and calls will be answered in as timely a fashion as possible. Please utilize our website for making payments and to submit changes to your policy. **

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What is Event Liability Insurance?

Did you know Special Event Liability Insurance provides you and your ensemble with protection for third party bodily injury and property damage arising out of an event?
Whether someone falls and gets hurt or damages someone else's property, we can provide protection to you by assuming the risk of legal claims brought by a third party. We can cover many types of events from fairs and festivals, consumer shows, fundraisers, dances, meetings, luncheons, parties, weddings, concerts, and more.

Even if the venue you are performing at has their own insurance it covers Them Not You! Who pays for your legal defense if you a brought into a lawsuit?
Even if you are cleared of all wrongdoing you could be out of thousands of dollars in legal fees. The cost to hire a lawyer to defend You starts at $250.00 per hour and up. This is an inexpensive way to protect yourself and your ensemble from potential losses arising for negligent acts you may or may not have committed.

Please fill out this form as best you can and then contact us at 1-800-VIVALDI that is 1-800-848-2534, Ext. 111 to learn how to protect yourself & relax…
At CLARION We've Got You Covered!

Special Event Liability Questionnaire
*please fill out the form below to provide us with information regarding your event
* = Required Fields
 Your Name:* Title:
 Your Organization
 or Business Name:
Company Address (Physical Address please, No PO Box Allowed):
 Street:  City:
 State:  Zip:
 Phone#:*  Cell Phone#:
 Fax#:  Org. E-mail:
 Web Address:
 Do you need a Short Term or Annual Policy:
 Is this for a single event lasting longer than 3 weeks?
 Are you an Event Organizer/Planner or an Exhibitor/Vendor?
 Event Detail:
 Please describe your
 event of service:
 Event Name:
 Event Website:  Venue Name:
 Venue Address:
 Event Start
 Event End
 Coverage Start Date:  Coverage End
 If the coverage start date is more than 5 days before the event start date or the
 coverage end date is more than 5 days after the event end date, please explain
 Is the Event Outdoors?
 How many years has this event been held under the present management?
 During this time has the insured had any claims regarding this event?
Type of Event?

 Maximum Daily
 Attendance #
 Total Attendance #  
 Average Attendance #  Gross Revenue $
 Number of Events per
 year for annual policies?
 Expenses $
Required Limits of Liability

Will your event include any of the following?
 The Serving of Beer, Wine or Alcoholic Beverages?
 Renting or using someone else's vehicle to get to and from the event or
 to deliver goods and equipment to the event?
 Did the Venue request a Certificate or Proof of Insurance from you?
 If yes, did they ask to be named as Additional Insured on your event policy?
 Did the Venue in a written contract require a "Waiver of Subrogation" Clause
 on the Certificate of Insurance?
 Are you renting equipment for your event?
 If yes who is insuring it while it is in your case, custody and control? Please explain
Will any of the events include any of the following?
Please check all that apply whether you, the venue, or a Subcontractor
(A Subcontractor is a 3rd Party who is part of the event but not necessarily hired directly by you.)
Please check off who is providing the insurance.
  Applicant Vendor/Exhibitor Subcontractor
Animals (other than pet contest & shows)
Cattle Drives
Childcare Operations
Firearms or ammunition
Food Vendor
Mechanical amusement rides
Motor Sports
Open water exposure
Rock climbing walls
Tattooing/Body Piercing
Temporary skating/skateboarding structures
Trail Rides

 Do you require all Vendors/Exhibitors managing any of the above indicated activities to have
 their own liability insurance in place listing you as an Additional Insured?
 Will any of the events occur in a bar or nightclub?
 If yes, are those events occuring in a bar or night club open to the public?
 Does the applicant hire any subcontractors for the insured event(s)?
 Do these subcontractors carry their own insurance naming you as Additional Insured?
 Will there be security at the insured event(s)?
 If yes, who is providing the security?
 Please provide what type of security is provided at the event
 If you hire a security company, does the security company carry its own
 insurance name you as the Additional Insured?