DJ, KJ, VJ Insurance Quote

Transcription

1 DJ, KJ, VJ Insurance Quote Selected Coverage 1. General Liability Insurance 2. Property/Equipment Insurance 3. Media Insurance 4. Crime Insurance Limit Selected 1,000,000/2,000, Total Cost: How to Purchase this DJ, KJ, VJ Insurance Policy: To purchase this policy, please go to sign in and complete the online application form. You can purchase your policy online and print your documents immediately. Questions? For any questions, please contact one of our customer service representatives, available Monday Friday from 8:30am to 5:00pm PST at or support@rvnuccio.com. Notes: 1. Date of quote: 2/18/ Quotation is subject to online completion of the application and underwriting approval. 3. Quotation is valid for 30 days. Must be purchased 24 hours in advance. 4. Prices subject to change without notice and may vary depending on the information you provide in the application. 5. Upon completion of the application, you will be provided with a final quote letter. 6. Licensing information available upon request. 7. Sample policy available upon request. 8. Policy is underwritten by an A+ insurance carrier. PAYMENT METHOD: CREDIT CARD R.V. Nuccio & Associates Insurance Brokers, Inc Riverside Drive Toluca Lake CA

2 DISC JOCKEY/KARAOKE JOCKEY/VIDEO JOCKEY INSURANCE QUOTATION Underwritten by Fireman's Fund Insurance Company Insured Company: Sound Prodigy Insured Name: Michael Connolly Proposed Effective Date: 2/19/2014 Date: 2/18/2014 Coverage Options Limit Cost DJ/KJ/VJ Property/Equipment Premium DJ/KJ/VJ Media Library Premium DJ/KJ/VJ Crime Premium DJ/KJ/VJ General Liability Premium ,000,000/2,000,000 State Guarantee/State Surcharges RVNA, Inc. Corporate Charge RVNA, Inc. Loss Payee/Mortgagee Charge RVNA, Inc. Additional Insured Charge Total Cost If you wish to purchase this exclusive insurance product please log in at 1. Select your application, and click on EDIT. 2. Review your application by clicking on CONTINUE. 3. Pay by credit card and print your policy in minutes. 4. Coverage must be bound through our automated online system at by 3/20/ :01:00 AM NOTES: UW ID #: Quotation is valid until 3/20/2014 Prices subject to change without notice It is the insureds responsibility to read the policy. It is available online at Payment Method: Credit Cards only R.V. NUCCIO & ASSOCIATES, INC RIVERSIDE DRIVE TOLUCA LAKE CA

3 Applicant Information First Name Michael Last Name Connolly Company Name Sound Prodigy Street Hwy 8 Bus #70 City Lakeside State CA Zip Code Applicant Home Phone (619) Applicant Business Phone (619) Applicant Fax (619) Website Address Address soundprodigy@cox.net Name of individual completing the application Michael P. Connolly Are you a DJ/KJ/VJ? Yes Number of Setups or DJs 2 Business Location Residence Are you a member of the American Disc Jockey Association? No How did you hear about us? ADJA ADJA Bridal Association of America GLOBALMOBILE San Diego Disc Jockey Association Yes NAME WEDJ.COM I do not belong to any association Coverages Enter coverage start date(this date should match your expiring coverage, if any) 2/19/2014 a. Select Liability Limit 1,000,000/2,000,000 b. Have you had any Liability losses within the last 5 years which may have been covered No by this type of Liability insurance? c. Do you understand and agree that coverage provided under the Commercial General Yes Liability section of the policy for a Disc Jockey or a Disc Jockey Company which was hired to provide Disc Jockey services limited to the playing of recorded music, including setting up and taking down supporting equipment, at a covered event? a. Total Business Personal Property/Equipment That You Own (Enter Dollar Amount) 0.00 b. Total Business Personal Property/Equipment That You Rent For Your Use (Enter Dollar 0.00 Amount) c. Total Business Media (Tape/CD/KD/LP) Library (Enter Dollar Amount) 0.00 d. Have you had any Property losses within the last 5 years which may have been covered No by this type of Property insurance? I understand and agree. Yes a. Select Crime Limit No, I do not want to purchase this coverage. b. Have you had any Crime losses within the last 5 years which may have been covered by this type of Crime insurance? Broker Fee (Enter Dollar Amount) Other than a portable portrait Photo Booth, do you provide any Photographer and/or No Videographer services?

4 I understand and agree that the underwriter retains the right to review the application for Yes accuracy, and that the policy will not provide any insurance coverage if any application information is falsely reported, falsely stated, incorrectly selected, stated, misreported, misrepresented, misstated or wrongly stated, whether or not intentional. I declare, under penalty of perjury, the information I have provided in this application is true and I have not withheld or misrepresented any facts. I understand and agree that by entering my name below, I am effectively signing this Yes application for insurance. First Name Michael P. Last Name Connolly Endorsement Date 2/19/ :01:00 AM Additional Insureds Additional Insureds Applicable AI Form Name Marina Village Street 936 Quivira Way City San Diego State CA Zipcode Insured Wording Wedding Event Information Start Date 3/1/2014 End Date 3/1/2014 Start Time 4:00pm End Time 11:00pm Event Description Obney / Radford Ceremony And Reception ADD A CERTIFICATE OF LIABILITY Total Additional Insureds 1 Loss Payees/Mortgagees Cancellation Information Reinstatement Information

5 NATIONAL ALLIANCE OF SPECIAL EVENT PLANNERS, INC. COMMERCIAL PACKAGE POLICY Master Policy Number: XPK Endorsement Effective Date: 2/19/2014 Issuing Company: Fireman's Fund Insurance Company 777 San Marin Drive Novato, California Nationwide Claims: GENERAL CHANGE ENDORSEMENT 01. MEMORANDUM HOLDER NAME AND ADDRESS (MEMORANDUM HOLDER MEANS NAMED INSURED) a. Memorandum Holder: Michael Connolly b. Street Address: Hwy 8 Bus #70 c. City: Lakeside d. State: CA e. Zip Code: Memorandum Number: PEVD Endorsement Sequential Number: 30 National Program Administrator: R.V. Nuccio & Associates Insurance Brokers, Inc Riverside Drive Toluca Lake, CA Nationwide: COVERAGE PERIOD Inception Date 2/19/ :01A.M. to Expiration Date 2/19/ :01A.M. Standard Time at the Named Insured s address as stated above. 04. BUSINESS TYPE Disc Jockey/Karaoke Jockey/Video Jockey Photographer/Videographer Event Planner 05. TYPE OF ENDORSEMENT a. Addition b. Deletion c. Change New/Changed Coverages and Premiums Total Premium Detailed Policy changes are listed on the following page. 08. TOTAL AMOUNT DUE OR PAYABLE Additional Amount Due Return Amount Payable Date Issued: 02/18/2014 Form Number: NASEPDJFFICUWS060112A By Robert V. Nuccio Authorized Representative 01/07/2014 NASEPDJFFICUWS060112A.DOC Copyright All rights reserved. R.V. Nuccio & Associates Insurance Brokers, Inc. 1

6 GENERAL CHANGE ENDORSEMENT Continued From Previous Page

7 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC AUTOMOBILE LIABILITY CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER R.V. Nuccio & Associates, Inc Riverside Drive Toluca Lake, CA INSURED Sound Prodigy Hwy 8 Bus #70 Lakeside, CA COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE A XPK /19/2014 2/19/2015 1,000,000 DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) 100,000 Certificate #:PEVD CLAIMS-MADE OCCUR MED EXP (Any one person) 5,000 A ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA LIAB EXCESS LIAB SCHEDULED AUTOS NON-OWNED AUTOS OCCUR CLAIMS-MADE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below XPK Certificate #:PEVD CONTACT NAME: PHONE (A/C, No, Ext): ADDRESS: INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE WC STATU- TORY LIMITS E.L. EACH ACCIDENT FAX (A/C, No): OTH- ER E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT 02/18/2014 NAIC # Fireman's Fund Insurance Company /19/2014 2/19/2015 1,000,000 2,000,000 2,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured: Marina Village Wording: Wedding Desc: Obney / Radford Ceremony And Reception Start Date:3/1/2014 End Date:3/1/2014 CERTIFICATE HOLDER Marina Village 936 Quivira Way San Diego, CA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Robert V. Nuccio ACORD 25 (2010/05) ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

8 ISO Commercial General Liability Forms 01/01/96 POLICY NUMBER: Refer to COMMERCIAL Certificate of Insurance GENERAL LIABILITY Certificate Number: CG THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Designation of Premises (Part Leased to You): SCHEDULE 2. Name of Person or Organization (Additional Insured): 3. Additional Premium: (If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II ) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. CG NASEPWH055.doc Insurance Services Office, Inc., 1994