Kiosk Liability InsuranceKiosk Liability Insurance
Kiosk Insurance
(Mall Displays/Kiosks)
There cannot be any alcohol sales, use of a grill, deep fat frying, body piercing, tattooing or any type of professional liability exposure. No sports related groups, dancing schools, where d...
Kiosk Liability Insurance
Kiosk Insurance
(Mall Displays/Kiosks)
There cannot be any alcohol sales, use of a grill, deep fat frying, body piercing, tattooing or any type of professional liability exposure. No sports related groups, dancing schools, where demonstrating or competing. No Fireworks, hazardous materials or highly flammable goods. No imported toys, web design or computer related operations.
1. Effective Date: (mm/dd/yyy) _________ 12:01am Expiry Date:___________12:01am
2. Location of the kiosk/booth (name & address):
_______________________________________________________________________
3. Products / Services offered:
_______________________________________________________________________
_______________________________________________________________________
4. Anticipated receipts _____________________
5. Expected attendance at the booth/ kiosk up to 1000/ day / Other: _________________
6. Limit of liability: $1 million $2 million $3 million $4 million $5 million (Please circle)
7. Additional Notes:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
8. Name and address of Insured:
_______________________________________________________________________
_______________________________________________________________________
9. Insured’s signature: ______________________________________
10. Phone: _____________________________Fax # : ______________________________
11. Position / Title: ___________________________Date: __________________________
12. Name of applicant / Insured:
_______________________________________________________________________
13. Mailing address:
_______________________________________________________________________
_______________________________________________________________________
14. Contact name: ___________________________________________________________
15. Phone #: _______________________________________________________________
16. Website of insured: _______________________________________________________
17. Additional Insureds Name & Address
_______________________________________________________________________
_______________________________________________________________________
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