Art Elite Insurance Application Form
"As an active response to your fine art needs, we have created a quorum where experienced underwriters, fine art loss adjusters, fine art risk managers, and fine art conservators actively communicate with you to minimize risk and claims."
Applicant Information
1. Name:                              
2. Mailing Address:           

                                              City:   State:   Zip:
3. Contact Name:                
4. Email Address:               
5. Phone Number:                
6. Website:                           
7. Proposed Start Date:       
8.          
Insurance Limits
9. Total Limits:                   
    Premises:
     Location 1 Address:
     Location 1 Values:   
     Location 2 Address:
     Location 2 Values:    
     Location 3 Address:
     Location 3 Values:    
     Location 4 Address:
     Location 4 Values:    
10. Transit Limit
       (any single transit):   
11. International Limit
      (any other location):  
12. Earthquake Limit:      
13. Deductible:            
                                 
14. Current Carrier: 
15. Expiration Date:   
16. Premium:              
17. Broker:                 
      Inventory:
      Antique Furniture           Painting                               
      Arms & Armor               Photographs                      
      Tapestries, Rugs, Fabrics           Prints                                    
      Enamels                       Drawings                             
      Glass & Ceramics      Sculpture (fragile)             
      Instruments                  Sculpture (not fragile)      
     Antique Jewelry           Rare books/manuscripts
     Other                         
18. Describe any claims or losses in the last 5 years (please note insurance company and amount paid):
     
Practice
19. Years in Business:      Annual Receipts:
20. Affiliations & Assn Memeberships
21. How is Art Stored?
22. Do you use Consignment Agreements? (Check if yes; Uncheck if No)
23. Do you use Loan Agreements?
24. Are inventory records kept electronically?
25. Do you use digital cameras to document artwork?
26.Do you subscribe to Art Loss Register?
27. Does your current insurance program provide Agreement, Transportation, and Security Reviews or Consultation?
Location(s)
28. Building Construction          
29. Year Built    Square Footage 
30. Describe updates to roof, plumbing, and/or electrical for Buildings over 25 years old:
31. Do you have a written safety program & catastrophe plan?
32. Is their a Central Station Alarm at the premises?
33. Is the alarm outfitted with Motion Detectors?
34. Does the alarm include door and window contacts?
35. Does the alarm include fire protection?
36. Does the building have fire sprinklers?
Transit and Transportation
37. Value of Domestic Shipments:
Art Shows or Fairs You Expect to Attend (or attach separate list) Value of art you expect to show
38. Value of Shipments Abroad:     
39. Average Shipment Value:          
40. Maximum Shipment Value:       
41. Which Transportation Services Do You Use?
Signatures
42. Applicant Signature                  Date
43. Insurance Broker Signature   Date

Program Loss Control
Loss Control for the program puts focus on a number of items - most revolving around physical security and protocols for maintaining that security. We know you don't consider your art a commodity.

We are a quality solution provider, and make available to our clients a number of services that go beyond the commodity mentality. Your art is important to us too.

Our loss control matrix includes the following. Please check which items are most important for your needs and well being: