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Fairgrounds Festival

Fairgrounds Festival

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Contact Information

Paula Case

1-800-265-8098 ext 235

paula.case@palcanada.com

My regular office hours are Monday- Friday, 8:30 am to 4:30 pm Eastern Time



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Section 1

Reference #
39-88211


Is the kiosk located OUTSIDE of Canada?
*If yes, we will only offer Commercial General Liability Coverage ONLY, please provide additional details of event name and dates in comments section.* 
               
Square Footage: * 
 
Term Selection: * 
 
Effective Date: * 
 
End Time: 
   
Do you require coverage if someone is injured by a product you make or sell (Not including Food or Beverage), or by work you have completed? (eg. Products and completed operations): * 
               
Limit of Liability (million): * 
 
Does your product or work involve any of the following:
(If yes, please enter details of your product or work in the below field called "Description of services" found in section 2 of this application)* 
               
  •  Amusement devices
  •  Athletic Performances and Stunts
  •  Arc Welding and or Soldering
  •  ATM
  •  Baby Products
  •  Body Piercings, Permanent Tattoo and or Permanent Jewellery (on site)
  •  Cannabis
  •  Chemicals
  •  Christmas Tree Lot
  •  Explosives (Including Fireworks / Pyrotechnics)
  •  Flames/Fire
  •  Fertilizers
  •  Games
  •  Goods on Consignment and or Unattended booth
  •  Health and Wellness testing including but not limited to treatments/services with respect to medical rehabilitation, wellness, physiotherapy
  •  Heating Pads/Blankets
  •  Henna Tattoo
  •  Hookah bar/services
  •  Installation
  •  Licensed or unlicensed motorized vehicles
  •  Liquid Nitrogen
  •  Live animals
  •  Lottery Sales
  •  Massage and massage products
  •  Mechanical bull
  •  Oxygens / aromatherapy bars
  •  Pesticides / pollutants
  •  Pharmaceuticals, nutraceuticals
  •  Photobooth
  •  Pre-Packaged Prepared Foreign Food
  •  Providing Professional treatments such as chiropractic care, hair care, massage
  •  Seafood/Fish ( including Sushi)
  •  Service or repair of products (on site)
  •  Time shares sales
  •  Tobacco
  •  Tarot Card/Mediums/Fortune tellers
  •  Toys that are Powered and or Riding
  •  Virtual and/or Virtual Reality Setups
  •  Vitamins, Health or Dietary Supplements
  •  Watercraft exhibits in water
  •  Weapons (including but not limited to knives, firearms, material arts accessories)
  •  Weight loss plans or products










Will you have candles at your booth?: * 
 
 
 
 
Are you doing E-Commerce (Online Sales) at your booth?: * 
 
 
 
 
Are you operating an artist studio at your private residence as part of a studio tour?: * 
               
Will you be selling skin care products/cosmetics including, but not limited to: lotions and soaps?: * 
               
Do you require loss or damage coverage to your own property in your own vendor space?: 
 
Will you be setting up at two different locations on the same day?: * 
               
Only ONE booth/kiosk/table or stand will be setup at any ONE given time. Additional set ups to be added by endorsement, subject to underwriting approval. Additional premiums may apply.: * 
        
I hereby understand and agree that the following property is excluded: Jewels, jewellery, fine art, precious stones, antiques, furs, plants, shrubs, money and securities, automobiles, motorcycles and any other vehicles licensed for the road.: * 
               
Will you be serving or selling food or beverages?: * 
               
Will a deep fryer be used on site?: * 
               
What type of fire suppression system will be used?: 
   
Is this a Food truck and or trailer?: * 
               
Will you be serving alcoholic beverages at your booth? (may incur additional premium): 
               
If cooking/preparing food and/or beverages for onsite consumption has the health authority/department approved your food stand licensing? (If you are unsure of their requirements you will need to contact your Community Health Services Department to verify): 
        
Do you require coverage extension to a commercial kitchen? (may incur additional premium)
               

Section 2

Name of insured: * 
   
Address: * 
   
City: * 
   
Province: * 
 
Postal Code: * 
   
Phone Number: * 
   
Email: 
   
Contact Name: * 
   
Website: 
   
Description of products or services for sale or promotion at the booth, kiosk or table: * 
   

Section 3

Name of location: 
   
Address of location: 
   
City: 
   
Province / State: 
 
Location Postal Code: 
   
Additional Insured: 
   
Do you need to name any additional insureds with respect to any shows you will be exhibiting at?: * 
               
You can request future endorsements to add additional insured during the policy term. No Endorsement fee will be imposed for this type of request. However, any other type of endorsement request may be subject to an endorsement fee and / or additional premium.

Section 4

Add Additional Insured: If an additional insured is required to be named, please describe the additional insured relationship to the event. Select if the additional insured is an Event Organizer, the Event Venue or Event City/Municipality and provide their name and address, the event name and address and the dates you will be exhibiting at the event. Then select the ADD ADDITIONAL INSURED. You may add more additional insureds by repeating these steps.
Type: * 
 
 
 
 
Name Of Additional Insured: * 
   
Address:    
   
City:    
   
Province:    
 
Postal Code:    
   
With respect to the event:
Event name: * 
   
Event Address:    
   
Event City:    
   
Event Province:    
 
Event Postal Code:    
   
Start Date: * 
 
End Date: * 
 


Section 5

Please describe the type of property: 
   
Where will you store the property when not in use?: 
   
Full property address: 
   
Locked Doors: 
               
*Property must be stored at a location with locked doors or a working alarm or 24 hour security while not in use.
Is the premise sprinklered: 
               
Are there security personnel on site: 
               
Is there 24 hour security: 
               
Are there security cameras on site: 
               
Is the premise alarmed: 
                             
Are there additional security measures while NOT in use: 
   

Section 6

Are you the insured?: 
        
Premium is FULLY EARNED, no return premium on cancellation. Please click yes to confirm that you agree: * 
        
Name of person completing this form: * 
   
Mailing Address of person completing form: * 
   
City: * 
   
Province: * 
 
Postal Code: * 
   
Phone Number: * 
   
Email: * 
   
Verify Email: * 
   
I /We hereby declare that the answers and declarations above, whether in my own hand or not, are true and that I /we warrant that no material fact has been withheld or misstated and agree that this proposal will form part of the policy and will form the basis of the contract with underwriters. I /we understand that the underwriters may declare any policy issued void in the event of any false statement, misrepresentation, omission or concealment whether made intentionally, innocently or accidentally. For purposes of the Insurance Companies Act (Canada), this document was issued in the course of Lloyd's Underwriters' insurance business in Canada
I/we agree: * 
        
Check to confirm: * 
        
I have reviewed the information above and have ensured it is 100% accurate. I have also included any Additional Insureds that may be required within the Venue’s rental agreement/requirements.
How did you hear about us?: 
 
If other, please specify: 
   
   

HELPFUL INFORMATION

Here are a few things to try to get your certificate successfully:
  1. Check the screen for any error messages. They will appear in red above the location of the error.
  2. Double check your information to make sure it has been entered correctly.
  3. You can always start over from scratch if you are having issues.
  4. You may want to try a different browser. Sometimes the settings of a certain browser may cause a problem and using a different browser will allow you to complete your submission.

 

CUSTOMER SERVICE

E-mail:  ontario@palcanada.com
Phone: 1-800-265-8098 Ext 828
Hours: Ontario 8:30am to 4:30pm EST Alberta 8:30am to 4:30pm MST

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