TULIP Application - Morrow Insurance Agency, Inc.

Tenant User Liability Venue Application

Tenant User Liability Insurance Program Application

If you are human, leave this field blank.

Venue Name: *

Contact Name: *

Website/URL *

Address *

Address

City

State/Province

Zip/Postal

Phone Number *

Fax Number

Email Address *

Number of Years in Operation *

Types of events that are typically run at the venue *

Number of events planned in the prior year *

Number of events planned for upcoming year *

Average number of attendees for the events *

Maximum number of attendees for any one event *

What is the type of venue?

Convention Center

Hotel

Conference Center

OtherOther

Previous Coverage

Carrier

Effective Date

Limits

Premium

Losses

Carrier 2

Effective Date 2

Limits 2

Premium 2

Losses 2

Coverage from

Coverage to

Supplemental information needed. Please attach the following: client contracts, vendor contracts, venue contract and currently validated loss run (3 years minimum)

Drop a file here or click to upload Choose File

Maximum upload size: 67.11MB

Please provide specific additional insured wording:

Please provide a list of all locations to be included under this venue:

Name of Applicant *

Title *

Questions?

Please contact our Camp Department at 828-693-5396 for further assistance.

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