Application for Event Cancellation, Physical Loss to Personal Property and Door Registration Receipts Cover. INFORMATION Contact Name: 1. Assured Name: 2. Full Address: 3. Street Address City, State, Country Postal Code E-mail: 4. Telephone: 5. Facsimile: 6. Event Information NOTE: If you require coverage for more than one event, please view the special note at the end of this application. Do you want to Insure: Gross Revenue Costs and Expenses 7. Is cover required for more than one 8. Yes No Event? Name of Event: 9. Type of Event: 10. E.g.: Exhibition, , Product Demonstration, Dance, Regatta (Rowing), Garden Show, Dinner, Parade, Cycling, etc. Event Dates: To: 11. (dd (dd mm / yyyy) mm / yyyy) / / Total sum to be insured: Currency: 12. NOTE: Your claim will be reduced if you do not insure the total amount of your exposure VENUE
Application for Event Cancellation, Physical Loss to Personal Property and Door Registration Receipts Cover. 1. Contact Name: 2. Assured Name: 3. Full Address: Street Address City, State, Country Postal Code 4. E-mail: 5. Telephone: 6. Facsimile: Event Information NOTE: If you require coverage for more than one event, please view the special note at the end of this application. 7. Do you want to Insure: Gross Revenue Costs and Expenses 8. Is cover required for more than one Event? Yes No 9. Name of Event: 10. Type of Event: E.g.: Exhibition, , Product Demonstration, Dance, Regatta (Rowing), Garden Show, Dinner, Parade, Cycling, etc. 11. Event Dates: (dd / mm / yyyy) To: (dd / mm / yyyy) 12. Total sum to be insured: Currency: NOTE: Your claim will be reduced if you do not insure the total amount of your exposure VENUE INFORMATION
Prop-Form-fill.docx