Loan Out, Personal Service, Shell Corporation Insurance Application
APPLICATION for: Loan Out Corporation, Personal Service Corporation, Shell Corporation Notice: The Policy for which this Application is made, subject to its terms, applies only to any Claim (as applicable in the Coverage Section for which Application is made) made against any of the Insureds during the Policy Period. The Limit of Liability available to pay damages or settlements shall be reduced and may be exhausted by amounts incurred as Costs, Charges and Expenses (as defined in the Coverage Section for which Application is made), and Costs, Charges and Expenses shall be applied to the retentions. Submission of this Application does not guarantee coverage. General Instructions for completing this Application: 1. The Application must be signed by an executive officer. 2. This Application and all exhibits shall be used for purposes of this coverage only. 3. The terms as used herein shall have the meanings as defined in the Policy. SECTION I. GENERAL INFORMATION 1. Policy Number (if applicable): Name of Applicant: Address: City, State, Zip: Phone No.: Fax No.: Email: SECTION II. PROGRAM DEFINITION Program Definition: This program is designed for individual members of the entertainment industry who have achieved a degree of commercial success which dictates that they incorporate for business conduct purposes. They purchase commercial insurance because they have created a legal corporate entity. Risks that fit this program include; actors, directors, producers, writers, cameramen, singers, musicians, composers, radio/TV broadcasters, athletes, coaches and trainers etc. 2. Describe the applicable fields: 3. List the professional credits of this applicant (i.e., titles of last movies worked on; significant past performances; titles and success of last recordings; major awards received or nominated for; reasons for commercial success, etc.): 4.
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