2019 abilitystrong parade user liability

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PARADE USER LIABILITY APPLICATION KALIFF INSURANCE 2009 NW Military Hwy, San Antonio, TX 78213 Phone 210-829-7634 Fax 210-829-7636 E-Mail: [email protected] Endorsement Request Form DATE:_________________________ INSURED:_________________________________________By:______________________________________ EVENT SPONSOR:_ disABILITYsa, disABILITYsa Creative Services, Fiesta Especial _____ PARADE NAME:____________________________________________________________________________ __________________________________________________________________________________________ EVENT DATE(S):____________________________________________________________________________ PARADE UNIT TYPE: ________________________________________________________________________ PARADE UNIT TYPE: ________________________________________________________________________ MOTORIZED FLOAT/# OF PERSONS___________________________________________________________ MOTORIZED FLOAT/# OF PERSONS___________________________________________________________ PREMIUM:______________________ Kaliff Parade Pricing PARADE UNIT PREMIUM MOTORIZED FLOATS PREMIUM Equestrian Units $165.00 per Unit 5 or less people on float $259.00 Marching Units $57.00 per Unit 6-12 people on float $361.00 Floats on Pickups $176.00 Each 13-20 people on float $498.00 Floats on Flatbeds $176.00 Each Motorcycle Units $165.00 per Unit Convertibles/Pick Ups $138.00 per Unit I choose to decline insurance and provide Certificate of Insurance (See Sample) X______________________________________ Parade Participant 2019 abilitySTRONG Parade Saturday, October 26th, 2019

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PARADE USER LIABILITY APPLICATION KALIFF INSURANCE 2009 NW Military Hwy, San Antonio, TX 78213 Phone 210-829-7634 Fax 210-829-7636 E-Mail: [email protected]

Endorsement Request Form

DATE:_________________________ INSURED:_________________________________________By:______________________________________ EVENT SPONSOR:_ disABILITYsa, disABILITYsa Creative Services, Fiesta Especial _____ PARADE NAME:____________________________________________________________________________ __________________________________________________________________________________________ EVENT DATE(S):____________________________________________________________________________ PARADE UNIT TYPE: ________________________________________________________________________ PARADE UNIT TYPE: ________________________________________________________________________ MOTORIZED FLOAT/# OF PERSONS___________________________________________________________ MOTORIZED FLOAT/# OF PERSONS___________________________________________________________ PREMIUM:______________________

Kaliff Parade Pricing

PARADE UNIT PREMIUM MOTORIZED FLOATS PREMIUM Equestrian Units $165.00 per Unit 5 or less people on float $259.00 Marching Units $57.00 per Unit 6-12 people on float $361.00

Floats on Pickups $176.00 Each 13-20 people on float $498.00 Floats on Flatbeds $176.00 Each Motorcycle Units $165.00 per Unit

Convertibles/Pick Ups $138.00 per Unit

I choose to decline insurance and provide Certificate of Insurance (See Sample)

X______________________________________ Parade Participant

2019 abilitySTRONG Parade

Saturday, October 26th, 2019