In order for us to order your California Special Event Coverage, the form below must be filled out COMPLETELY. All fields (except fax number) are REQUIRED! You may order 24 hours per day from this site, but if ordered after 3:00pm (Monday-Friday) or on Weekends, the approval will not be delivered until the following business day.

If you need an SAME DAY issuance, policies can usually be approved by TELEPHONE if you call toll free:

Good News! We can now obtain insurance for Special Events in ALL STATES on simple events!

Special Event coverage for $441.50 is normally a "guarantee issue" if you can answer YES to the following statements:

• This event will be 1 day and have attendance LESS than 1000.
• This event has no "rap", "hiphop", "techno", or other such kinds of music.
• This event is NOT a sports event involving athletic participation.
• This event does is in California.
• You do NOT need alcohol liability coverage (there is no charge if alcohol is being served, or alcohol is being served by someone other than people in your organization).
• This event is essentially a wedding, party, office party, barbecue, charity event, dance, concert, exhibit, or other such simple event.

If your event qualifies for our "on-line" Event Program the cost is Just $441.50 for $1 Million coverage. Order now and save $75.00.

NOTE: If your event does NOT qualify - it does not mean we cannot write it! Most times, events that do NOT qualify for on-line issue can be issued at nearly the same price, but require quoting and approval, so send in the order form NOW. (Adding "food coverage" usually increases premium by $50.00, adding "alcohol" or "sport coverage" usually increases price by $100-$300). We'll find you the LOWEST PRICE possible!

Do You Qualify for the $441.50 Event Program?	Yes - Issue it! No - please quote Just Quote for now
Your Name
Street Address:
City:
State:
Zip/Postal:
E-Mail (REQUIRED):
E-Mail (again for accuracy):
Phone:
Fax: (Optional)
Event Details
Date(s) of Event:
Describe Event in DETAIL:
Event Location (address):
Number in attendance:
Will food be served?	Yes No
If yes to food, describe:
Will Alcohol be served?	Yes No
If yes to alcohol, describe:
Describe security at event:
Describe music if any, at event:
Is there a cover charge? If yes, estimate receipts:
Approximate square footage of location you are using:
Name and Address of Additional Insured, if any (usually the facility):
Send my Quotation Results via:	Fax E-Mail Regular Mail

Enter Your Credit Card Information

Thank you for filling out this form COMPLETELY! We deem your data submitted as PRIVATE information. Every step has been taken to insure your privacy, security, and to release this information only to you. By checking the box below you agree to allow Basic West Insurance Agency to release this information via the method you have chosen, and to release them from any liability should this information be accidentally viewed by others. Also, the insurance carriers reserve the right to issue coverage or not, and we cannot guarantee acceptance of a risk until approved by the company. Special Event Insurance is NON-REFUNDABLE once ordered and paid for, so if you have ordered the INSTANT ISSUE coverage, the policy will be issued, and you agree to pay for it. Yes, I Agree. Please Order My Event Coverage! Yes, I Agree - but I only want a quotation right now!

---

 

Thanks for using our services!

© 2,002 (Basic West Insurance Agency, Inc.)

1641 Taraval Street - San Francisco, CA 94116
(415) 665-7400 - fax: (415) 665-7713
Insurance License #0664506
E-Mail us at:
basicwest@aol.com