Art Installation | Burning Man Liability Insurance Program

ART INSTALLATION INSURANCE QUESTIONNAIRE
Artist Information
Name* Contact Person*
Legal Entity (if any)
Address*
City, State, ZIP*
Phone* Fax
Email * Website
Numbers of Years Attending Burning Man
General Liability
Arrival Date: Departure Date:
Description of art:
Is your installation participatory (e.g. Climbing, Suspending, and/or Swinging)?:
Will participants climb or suspend over 25 feet in the air?:
Does your installation involve pyrotechnics? If so, please explain.
Property Exposure (If property damage coverage is needed)
Art / Equipment Value
How will you transport equipment to the playa (i.e., car, trailer, 3rd party shipper)?
Do you have an art car(s)? If so, please complete the Art car questionnaire. Liability coverage for art cars is not included in both the theme camp and artist liability coverage.

Do you require a Loss Payee, Evidence of Insurance, or Additional Insured Certificate? If so, please provide the certificate holder's name and address. Please also include any special wording instructions.

877-731-7905