All-Weather Insurance Agency - Weather Promotions

Quote Request (Weather Promotions)

Contact Information - **Please note that there is a $1,000 minimum premium amount applicable to all policies**

* Required Fields

Name:*

Company:*

Address:*


City:		State:		ZIP:

Phone:*

Fax:*

Email:*

Insurance Broker:

Yes \| No
If (Yes), Name of Agency:

Coverage Information - please fill in all fields

Promotion Name:
Promotion Location:

City:
State:	ZIP:

Promotion Type:

Web-Address:

Total Amount of Coverage Requested:

Previous Weather Insurance:

a) Has this event been insured before? Yes \| No
b) If Yes, with which Insurance Carrier?:

Sales Period Coverage:

Beginning Date
Ending Date

Weather Peril Date:

Hours of Coverage:

hours to hours

Amount of Insurance Requested $
Note: This will be used as your initial policy limit to be adjusted at end of promotion based on actual sales.

Please select the weather coverage desired:

a) Rainfall: (inches) or more of rainfall

b) Snowfall: (inches) or more of newly fallen snow

c) Temperature: (Fahrenheit) maximum/minimum/average

d) Wind Speed: (mph) maximum/minimum/average

Claim Settlement:

Closest Hourly National Weather Station to the Event Location(s):

Independent Weather Observer on- or off-Location: