Welcome to Holman Insurance Brokers on-line Entertainment Liability Insurance quick quote page. Please ensure you complete the form as accurately as possible in order to ensure the best possible estimate. If you would rather speak to one of our sales representatives, please call us at (905) 886-5630 or 1-800-567-1279.

Completion of this form is for informational purposes only, and is just an estimate.
This WILL NOT result in a new policy, or change to an existing policy.

* Required Fields

Contact Information
Company Name*
Contact First Name*
Address*
Contact Last Name*
City*
Phone*
Province*
Phone 2
Postal Code*
Fax
Web Site
E-Mail*
Please specify your preferred method of contact:
Phone Email
Insurance Information
Are you presently insured? If yes, what company?* (enter "none" if answer is no)
Policy Number* (enter "none" if you do not have a policy number)
Expiry Date
What is your current annual premium?
$
Why are you looking for a new insurer or broker?
Company Information
Please check each that applies to your organization:
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Group practice
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Occupation
Full Time Employees
Specialty
Part Time Employees
Annual Sales
$
Annual Payroll
$
Liability Information (Specify limits where appropriate)
Aggregate Limit Requested
Claim History
Information
Claim 1
Claim 2
Claim 3
Claim Status
Open Closed
Open Closed
Open Closed
Claimant Name
Date of Occurence
Location of Occurence
Insurance Carrier
Amount Paid on your Behalf
Amount Reserved on your Behalf
Allegations
Additional Comments



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Thank you for trusting Holman Insurance Brokers Ltd. for your insurance needs, one of our representatives will contact you soon with your quote!
Entertainment Liability Quote