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  baseball coverage application  
 
* = Required to obtain a quote/contract.
Name of the applicant: spacer
Mailing Address:  
City:  
State:  
  Zip:  
Business Applicant:
 
Applicant is a:
  
Corporation
Individual
Partnership
Name(s) and Title(s)
of Principal Officers,
Partners or Individuals:
 
Type of event(s) to be insured:
 

Convention with Exhibits
Convention with out Exhibits
Sporting Events
Trade Show open to the Public
Trade Show not open to the Public
Concerts
Other
Give name and detailed description of event(s):
 
If any printed material is available about this event, enclose a copy with application. If not available, send a copy of previous year's material.
Facility Information Itinerary:
   
Name:
  
Location:
  
Description of Structure:
 
Date(s) of Use
 
From: To: Dates of Events:
If more than one location is used, provide supplemental itinerary with the above information.
Have lease agreements with
the facility(ies) been signed?
 
Yes No
 
If "YES" please attach copy(ies)
 
If "NO" please explain
Describe contingency arrangements (if any) to use alternate locations
and the additional expenses that would be incurred (if any).
 
Are you aware of any extraordinary conditions, either existing or imminent, which might result in the unavailability of the facility(ies) scheduled for the declared event(s) such as a facility still being under construction:
Yes No
Have you operated or managed this event before?:  
Yes No
If "YES", how many times/years?  
If "NO" have you operated or managed similar events before?   Yes    No
If "YES", please describe:
Have you had any previous cancellation of this similar event(s) whether insured or unisurend?   
Yes    No
If "YES" please describe (i.e. date(s) of loss(es), circumstances and amount(s) paid):     
 

Definition of Loss    
The definition of loss is to be determined by the Applicant and only the items and Respective amounts specified in the "definition of loss" will be paid as indemnity in the event of a claim hereunder, not to exceed the actual ascertained loss not the selected limit of liability.

The ascertained net loss of actual expenses, cost, guarantees, irrevocable commitments, including advertising, promotion and exploitation professional performances fees or other remuneration which are necessarily sustained and actually incurred by the insured or, prior to any loss, were paid or contracted in writing to be paid, including aborted costs and expenses and/or relocation the event(s) canceled as a result of a contingency insured hereunder, or

The ascertained net loss of Total Gross Revenues, which means those monies agreed or contracted in advance in writing, from all sources less any and all savings of expenditures effected; or

The ascertained amount of actual refunds of advance ticket sales less any costs or expenses not incurred as a result of the cancellation, but including guarantees, irrevocable monetary commitments, including advertising, promotion and exploitation costs, and/or contracted professional performance fees or their remuneration which, prior to any loss, were paid or contracted in writing to be paid; or

Other (specify)

NOTE: THE PREMIUM PAID FOR THIS INSURANCE IS DEEMED NOT TO BE AN EXPENSE OR COST IN ASSESSMENT OF ANY LOSS HEREUNDER
     
Policy limits desired:  
Policy period desired:   From To
THIS APPLICATION IS SUBMITTED WITH THE FOLLOWING SPECIFIC
UNDERSTANDING:
  1. Applicant warrants and represents that the above answers and statements are in all respects true and material to the issuance of an insurance policy and the Applicant has not omitted, suppressed or misstated any facts.

  2. If a policy is issued hereafter, this Applicant shall be attached to and become a part such policy.

  3. The signing and filing of this Application does not bind the Applicant
  4. All exclusions in the policy apply regardless of any answers or statements in this Application.

  5. Any material change to the Company's exposure must be reported prior to coverage applying.We have read the above and agree that to the best of my/our knowledge and belief the foregoing fully represents the true statements of facts.
Applicant:  
By:  
Title:  
Date:  
Broker:  
Address:  
Telephone:  
     
Call CGA with your promotion details:
800-242-7789/Fax: 574-271-1747 or email: info@cgainc.com
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12748 Sandy Drive, Suite 110 P.O. Box 518 Granger, IN 46530
(574) 273-5625 (800) 242-7789 Fax: (574) 271-1747
email: info@cgainc.com