GLOBAL ENTERTAINMENT

(Current clients only)

Name of insured
Insured's e-mail address
Date of shoot or event:
Address of shoot or event:
Name of Certificate Holder
Address of Certificate Holder:
Contact name
Contact Phone
Contact Mobile Phone
Contact FAX
Contact e-mail address
Date Certificate is needed by:
Certificate Holder is: (Check one)	Additional insured-Landlord for location Additional insured-Municipality for a permit Additional insured & loss payee for leased equipment *Loss payee ONLY for leased equipment Certificate is issued for Evidence of Insurance ONLY *Description of Rented equipment, including Replacement Cost Value and lease dates. Include year, make and model when renting vehicles.

Check one and include appropriate