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Hd_application

Traveler's TEE, Annual DICE Producer Application - Help

  • Coverage Options

         = required

      Effective Date Help2
      General Aggregate Limit
      Annual Gross Production Cost Help2
      Include Production Package Help2
      Blanket Additional Insured Help2
      Employee Benefits Liability Help2
      Hired and Non-Owned Auto Liability Help2
      Hired and Non-Owned Auto Physical Damage Help2
      Cost of Hired Auto Help2
      Payroll Company? Help2
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      Click on the sections below to continue.

  • Production Information

      • Type of Productions

             = required

          Choose all that will apply
          Commercials Documentaries Still Photographer
          Music Videos Training Films Post Production
          Cell Phone Production Public TV Film Festival Reel
          Industrial Film Infomercial Corporate Video
          Video Game Shoot Video Location Survey
          Number of Productions Help2
          Largest Production Help2
      • Stunts & Hazards

          Will your work during the policy period involve any of the following? Please check ALL that apply
          Pyrotechnics Stunts Animals Aircraft
          Railroad Equipment Watercraft Motorcycles Underwater Filming
          Racing Firearms including blanks
          Hidden Camera(s) Arial Photography
          Sporting events where the insured is the organizer or promoter
          Special effects, other than computer generated
          Contestants or Participants of any kind
          Locations underground, in caves or tunnels
          Reality TV or Reality Projects involving non-acting roles
          Extreme Locations or Activities
          (including but not limited to locations involving: extreme weather conditions; desert conditions; beaches; extreme elevations; or locations requiring on or underwater filming)
          Extreme Sporting or Physical Activities
          (including but not limited to: skateboarding; bungee jumping; roller blading; hand gliding; parachuting or mountain or rock climbing)
      • Locations

          Is the insured shooting in any of the locations listed? Please check ALL that apply
          Metro Los Angeles Metro San Francisco Metro New York City
          Alaska Hawaii Canada
          Anywhere else in California
          Within 25 miles of the Gulf of Mexico
          Within 25 miles of the Atlantic Ocean
          Anywhere else in the continental United States
          Anywhere outside of the USA or Canada
  • Company Information

         = required

      Company Name
      Type of Entity
      eMail
      Address 1
      Address 2
      City
      State/Province
      Zip/Postal Code
      Country
      Contact
      Phone
      Website
      Other Named Insured(s)
      Prior Declination(s)
      Help2 Attach
      Prior Losses
      Help2 Attach
  • Workers' Compensation

         = required only if Work Comp coverage is requested. Change the Limits below to indicate you want Workers Comp.

      Limits
      Stop Gap Employers Liability Help2
      Payroll by Class Codes(if any)# Part Time# Full TimeTotal Payroll
      4360 - Subsequent Production Operations
      9610 - Motion Picture Production
      8742 - Salespersons - Outside
      8810 - Clerical Office Persons - NOC
      4361 - Photography
      7607 - Video Post Production
      8803 - Computer System Designers or Programmers
      Total of All Payroll Classes
      Officers Names
      Workers compensation coverage is not provided for officers & owners. Enter the first name, last name and title for each officer/owner. Exclusions of coverage for stunts and hazardous activities will apply.
      Full NameTitle
      Identification Number
      An identification number  is required when binding Workers' Compensation coverage.
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