Puppeteer Insurance Application

This Liability policy protects the performing company or regional puppet guild, from liability claims arising from bodily injury or
property damage to third parties while you are performing or assembling at various venues. This policy does NOT provide
coverage to participants.
Underwriting eligibility requires that only trouping puppet individuals and companies and closely-related groups such as
regional puppet guilds are eligible for this insurance.
It is the type of liability insurance that many venues request. The coverage is for $1,000,000 of liability insurance, with an
aggregate of $2,000,000. Medical Expense coverage is $5,000 (per person). Product/Completed Operations is $1,000,000.
Advertising/Personal Injury is $1,000,000, and Damage to Rented Premises is $100,000 (each occurrence). There is no
deductible.
The policy runs annually from October 6, 2014 to October 5, 2015. This year’s premium is $330 for Puppeteers of America
members and $500 for non-members. The cost remains the same regardless of when you join. We strongly recommend
becoming a member of the Puppeteers of America to receive the lowest rate and the many additional benefits of membership.
*Membership contact information is listed below.
***I am pleased to announce the merger of Chicagoland Insurance Specialists Inc with Paczolt Insurance Alliance.
Paczolt specializes in performing arts, theatre, dance and special events.***
Certificate of Insurance requests should be requested by fax or emailed to [email protected] using the certificate request
form that will be mailed to all insurance members along with your initial certificate. Certificate requests cannot be taken over
the phone.
PLEASE NOTE: Molestation and abuse coverage is excluded under this policy and CANNOT be provided by endorsement.
Make checks payable to ICW and mail them to Randy Scheive at the address below. Please email all questions to
[email protected].
The Puppeteers of America
PO Box 6150
Villa Park, IL 60181-6150
PH (630) 430-0138 / FX (888) 333-1234
* Puppeteer Membership Information
Puppeteers of America: www.puppeteers.org
Application for Puppeteers of America Group General Liability Insurance
Are you a Member of the Puppeteers of America?:
If Yes, P of A #
Name of Applicant:
Name of Company/Guild:
Address:
City: State: Zip:
Phone: Fax:
Email:
Credit Card#
Exp Date:
Please circle one-
VISA
M/C
CVV#
DISCOVER
Phone: 708-215-5200
eFax: 888-333-1234
[email protected]