Special Event Oregon Insurance Quote

541-258-2131
2545 S 2nd Street
Lebanon, OR 97355
541-967-8062
1129 Hill St SE
Albany, OR 97322
503-769-7105
621 N 1st Avenue
Stayton, OR 97383

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Special Event Insurance

Rhodes-Warden Insurance

Insurance Quote Request

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To request a quote for special event insurance, complete the form below.

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Contact Information

First & Last Name ✶

Title

Email ✶

Phone ✶

Business Information

Business Name ✶

Doing Business As ✶

Street Address ✶

City ✶

State ✶

ZIP Code ✶

Fax

Business Type

Website

Event Information

Date(s) of Event ✶

Event Name ✶

Event Description ✶

Location of Event ✶

name of facility

# of years event held

years

Gross Receipts ✶

from all sources

Claims in the last 5 years? ✶

Yes No

Total Attendees

Attendees per day

per day

Total Volunteers

Volunteers per day

per day

Alcohol Served? ✶

Yes No

Transport Participants? ✶

Yes No

Board of Directors? ✶

Yes No

Event Activites

Parade

Rodeo

Amusement Rides

Fireworks

Food Vendors

Craft Vendors

Inflatables (bounce houses, etc)

Petting Zoo

Tractor Pull

Demolition Derby

Anything Else?

Comments

Which office should this request be sent to?

Office

Binding Agreement

I understand that insurance coverage is NOT bound or altered until I receive confirmation by an authorized representative of Rhodes-Warden Insurance ✶

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