Weather Insurance Application

Basic Customer Info

Producer/Promoter/Organization Name *

Contact Name *

Contact Email *

Contact Phone *

Mailing Address *

City, State & Zip *

Event Details

Name of Event *

Event Website: *

Venue Name *

Venue Address *

Description of Event: *

Event Start Date: *

Event End Date: *

Set Up Starts On: *

Take Down Ends On: *

Coverages Requested

Complete information for each day coverage is desired

Day 1

Date of Coverage *

Hours of Coverage:
(state begin time & end time) *

Limit of Coverage:
(state the amount to be paid if a claim is made) *

Day 2

Date of Coverage

Hours of Coverage:

Limit of Coverage:

Day 3

Date of Coverage

Hours of Coverage

Limit of Coverage

Day 4

Date of Coverage

House of Coverage

Limit of Coverage

Choose the Type of Coverage Desired

Total Rainfall

Hourly Rainfall

Temperature - Too Cold

Temperature - Too Hot

Snow Fall

Other Weather Event to be Covered

Follow Me

Nonprofits | Festivals | Events | Business Insurance | Other Programs