Special Event Application (For On-Line Submission ) Fill in the form below if you choose not to use the PDF verson.
Registration Form
EVENT INFORMATION FOR QUOTE
Agency & Contact Name:
Carter and Company, LLP - John S. Carter
Insured's Name:
Address:
Phone #:
Email::
Event Location
Facility Name:
City:
Type of Event:
Date of Event:
Attendance:
Security Provided:
Any Additional Insured Information
Rate Information Follow the simple steps below to figure your premium and submit the form.
Step 1: Determine the event category level.
Level 1
Level 2
Following is a list of events that do not meet the underwriting guidelines of our program:
vPyrotechnic Uses
My event type is not shown in any category above. I understand that I may not qualify for this program. Please give me a custom quote if possible.
Step 2: Determine Daily Attendance and check appropriate premium under level you chose above.
Daily Attendance
$ 299.86
$ 374.32
$ 452.83
$ 503.84
$ 633.38
$ 733.32
$ 874.30
$ 1,061.74
For Submission Only
Step 3: Multiple Day Events (if applicable)
Step 4: Click Submit Below.
