Video Application

Lic. #0555411
820 Pacific Coast Highway
Hermosa Beach, CA 90254


Name of applicant:*
Have you ever had a business insurance claim?:*  Yes    No
The applicant is:*
Business/Premises Street Address:
Business/Premises City:
Business/Premises State:
Business/Premises Zipcode:
Check here if mailing address is different
Phone Number: (ex: 8007263701)*
Email:*
Website Address:*
Operations:*  Photography
 Video Production
 Still Photo Rep/Still Photo Producer
 Post Production
 Web Services
 Make Up Artist/Stylist
 Advertising or Marketing
Does any of your work involve:*  Paparazzi
 Adult Content
 Stunts
 Racing
 Music Videos
 Aerial or Underwater Videotaping
 None of the above
Brief description of your work:*
Years under current business name:
Previous experience within your industry:
Do you have insurance now?:*  Yes    No
Average still or video gross production cost per job:*  what is GPC?
Average number of still shoots or video productions per month:*
Do you hire assistants or have employees (either part of full time)?:*  Yes    No  
Do you work outside USA?:*  Yes    No  
Do you rent autos(production vehicles, vans, motor homes, grip trucks)?:*  Yes    No  
Do you rent your camera equipment or your studio to others?:*  Yes    No  
Do you have another business?:*  Yes    No  
Year your building was built:*
Construction Type:*
Is it okay to send document to you via email?:*  Yes    No
How did you hear about TCP?:*
  I have answered the above questions truthfully and to the best of my knowledge. I understand that any intentional misrepresentation or fraudulent information used to purchase this insurance may result in declination, cancelation, or denial of my insurance coverage*
 I agree    I do not agree
Comments:
 I would like TCP to contact me regarding my Auto Insurance
 I would like TCP to contact me regarding my Home or renters Insurance
 I would like TCP to contact me regarding my Health/Life/Disability/401K Insurance
Submit to:

Are you a photographer?

Photographer's Quick Quote

Are you a production company?

Film Quote

Home Insurance Quick Quote


Auto Insurance Quick Quote





or call us at 1-800-726-3701