Special Events Insurance

One Day Event only chooses the top rated policies for you and we guarantee our coverage will meet all your venue's requirements!

Obama care

CIGNA Domestic

CIGNA International

CIGNA Global Plans

info@insure123.com

408-286-1111

408-997-7890

CA Lic#

0697055

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CEO Zain Jeewanjee
Interview on WomenNow TV

Section 1: Submission Requirements
1)	Resume (New Business Only)	2)	Lease Agreement
3)	Daily Safety Checklist	4)	Diagram of premises
5)	Equipment List	6)	Safety Rules
7)	Waiver	8)	Loss runs for last 5 yrs.
9)	Business Plan (New Business Only)

Section 1B: Company Information
How did you hear about us? :
Business name:
Name of facility:
Contact first name:
Last name:
Phone number:
Your Customer's Email:
Website:
Date of Birth:
FEIN/SS#:
Mailing Address
Mailing Address:
City:
State:
Zip code:
Physical Address
Physical address:
City:
State:
Zip code:


Business type?	Corporation Partnership Individual Non-Profit Governmental Other
If other, please describe:
Year business was established:
Number of years under present management:
How many years of management experience do you have?
Do you ever process payment cards?	Yes No
Estimated annual number of payment card transactions:
Does the Applicant have a formal safety training program for employees?	Yes No
Does the Applicant have a safety manager on premises at all times the facility is open?	Yes No
If yes, please provide the name and contact information:

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Copyright 2005-2015 Jeewanjee Insurance Agency All rights reserved California Lic # 0697055
1494 Hamilton Ave #101, San Jose, CA 95125