party rental application

Step 1 of 3 - Company Information

33%

Section 1: Company Information

(Please check any you are interested in)

Policy

General Liability

Worker's Compensation

Accident Medical

Property/Inland Marine

Policy

Umbrella/Excess

Cyber Liability

Abuse/Molestation

EPLI

Section 1.2: Company Information

How did you hear about us?

Do you currently use any party rental software company?(Required)

Yes

Please provide party rental software company name:

Company/Business Name(Required)

Applicant Full Name(Required)

Year Business Started(Required)

MM slash DD slash YYYY

Phone Number:(Required)

Your Email Address(Required)

Website

Social Media

Entity Type:(Required)

Examples: Individual: Jane Doe DBA Jane's Bouncers, Partnership: Jane Doe & John Smith, Corporation: C Corp or S Corp, LLC: Jane's Bouncers LLC

Business Address(Required)

Business Address: City State ZIP Code

Mailing Address

Same as Business Address

Mailing Address

Mailing Address: City State ZIP Code

Projected Annual Gross Sales

Total Annual Gross Sales:(Required)

Desired Effective Date:

MM slash DD slash YYYY

Describe your operations- Check all that apply:

Backyard Birthday Parties

Parks

Corporate Events

Street Fairs

Carnivals

Events where you charge each participant

Other

Other:

Describe other

Section 2: General Information

Complete the following information, where applicable:

Describe/list specialized training - Check all that apply:

SIOTO

IAAPA

Manufacturer

IOA (Inflatable Operators Association)

Other

Other:

Describe Other

Are you currently insured?(Required)

Yes

Insurance Company Name

Premium

Expiration Date

MM slash DD slash YYYY

Do you have experience with inflatables?(Required)

Yes

Do you allow overnight rentals?(Required)

Yes

Do you have people that work for you?(Required)

Yes

Is equipment ever left unattended while set up at an event?(Required)

Yes

Are the inflatables set up on flat surface & properly secured?(Required)

Yes

Choosing No on this question will disqualify you from obtaining a quote.

Do you have Watchdog Siren Warning Devices?(Required)

Yes

Do you allow adults & children to jump at the same time?(Required)

Yes

Choosing Yes on this question will disqualify you from obtaining a quote.

Are there age, height & weight limits displayed clearly on all devices?(Required)

Yes

Choosing No on this question will disqualify you from obtaining a quote.

Are Rental Agreements signed by renters of the equipment?(Required)

Yes

Choosing No on this question will disqualify you from obtaining a quote.

Does your rental agreement contain hold harmless wording, release of liability and safety rules?(Required)

Yes

Choosing No on this question will disqualify you from obtaining a quote.

Do you maintain & operate equipment in accordance with manufacturer's instructions?(Required)

Yes

Choosing no on this question will disqualify you from obtaining a quote.

How often is equipment inspected for damages/safety?(Required)

Before & after each use

Weekly

Other

Do you allow customers to pick up inflatables?(Required)

Yes

Choosing yes on this question will disqualify you from obtaining a quote.

Do you want coverage on the equipment for fire, theft, vandalism and/or business income?(Required)

This will be an additional premium, you will need to provide values, and details of all equipment.

Yes

Are you a dealer or distributor of new or used inflatables, rides or equipment?(Required)

Yes

Do you subcontract equipment from other rental companies?(Required)

Yes

Interested in equipment/property coverage?

Yes

EQUIPMENT / PROPERTY

Currently insured?(Required)

Has Prior Insurance ever Been Cancelled / Non-Renewed?(Required)

100% Replacement value of building (IF OWNED)?

Number of stories?

Square footage of part of building occupied?

Square footage of entire building?

Building age

Do you rent any of your equipment to the sole care, custody and control of others?

Yes

If Yes, is this done for more than 25% of your business?

Yes

Equipment TOTAL VALUE (Replacement Cost) $?

Do you have any one single item valued over $5,000 (including sales tax)?

Yes

Where do you store your equipment majority of the time?

Does this place have an alarm system connected to an outside monitoring company?

Yes

Currently the policy has a Locked Vehicle Warranty. This means there is no coverage for theft from an UNLOCKED vehicle unless you elect to remove this warranty for an additional 10% of the premium. Would you like to remove this warranty for an additional 10% charge?

Yes

Have you ever had an equipment claim in the last 5 years?

Yes

Building Improvements / Updates

Wiring Year?

Roofing Year?

Plumbing Year

Fire Sprinklers?

Yes

Extinguishers?

Yes

Inventory List

Do you allow customer pick-up for any rental equipment?(Required)

Inflatables and Mechanical rides

Attach Separate Inventory List if needed

Items (including non-inflatable)

Sizes Length x Width x Height

Price

Non Inflatable Items (Tables, Chairs etc.)

Items (including non-inflatable)

quantity

Price

Section 3: Document Upload

You may also email documents after submitting the application.

Rental Agreement / Waiver

Max. file size: 80 MB.

Loss Runs (5 years)

Max. file size: 80 MB.

WARRANTY

(Applies to all parts of this application and attachments submitted) It is hereby understood and agreed that if insurance is issued by virtue of completing this application and any applicable supplemental applications, the Insurance is only issued on the reliance on the applicant’s warranty of answers to the questions above and on any such supplemental applications. If, at the time a certificate/policy is issued and ANY OF THE ABOVE WARRANTIES IS IN ANY RESPECT INCORRECT, INCLUDING CLAIMS OR GROSS RECEIPTS, THE COVERAGE AFFORDED UNDER THE CERTIFICATE/POLICY shall, without notice to the applicant, immediately and automatically cease, & the certificate/policy shall BECOME NULL AND VOID. Warranties will survive a certificate/policy if issued.

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Party Rental Application

Section 1: Company Information

Section 1.2: Company Information

Projected Annual Gross Sales

Section 2: General Information

EQUIPMENT / PROPERTY

Building Improvements / Updates

Inventory List

Section 3: Document Upload

WARRANTY

Company

Insurance Services

Contacts