Katt Insurance Agency - Specializing in Insurance for Campgrounds, RV Parks, and Golf Courses

Business Insurance - RV Park and Campgrounds

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NOTE: Fields with an asterisk (*) are required.

Principle Information
* Named Insured:
* Principal Contact:
Mailing Address:
City:
State:
Zipcode:
* Location Address:
City:
State:
Zipcode:
* Phone Number:
Fax Number:
Effective Date:
* Email:
Website:
Business Form:
Limit of Liability Requested: NOTE: General Aggregate is Unlimited
Prior Carrier information
Last Year
Insurance Carrier:
Limits of Liability:
Premium:
Two Years Ago
Insurance Carrier:
Limits of Liability:
Premium:
Three Years Ago
Insurance Carrier:
Limits of Liability:
Premium:
Loss History
Date:
Description of incident:
Amount Paid/Reserved:
Do you have knowledge of any incident which may lead to a claim?	Yes No
If yes, please describe:
Additional Insureds
Name:
Address:
City:
State:
Zip:
Interest:
Producing Insurance Agent
Agency:
Contact:
Address:
City:
State:
Zipcode:
Telephone:
FAX:
Management Information
How long have you owned this park?
Do you or your manager live on premises?	Yes No
Does the park have security patrol?	Yes No
If yes, is the security Patrol armed?	Yes No
Is the park fenced or gated?	Yes No
Is there a formal maintenance program for the grounds and landscaping?	Yes No
Is the electrical installation and maintenance done by a licensed electrician?	Yes No
Does the park/resort service or repair engines (RV, Marine, Auto)?	Yes No
Do you sell beer/wine/liquor?	Yes No
Is there a bar/lounge on the premises?	Yes No
If yes, is it open to the general/non-camping Public?	Yes No
Is your park a member of ARVC?	Yes No
Is your park a member of Good Sam Park?	Yes No
Is your park a member of any other state or regional association?	Yes No
If yes, please list:
Is your park a member of a franchise?	Yes No
If yes, what franchise:
Park information
Type of Guest Unit:	Number of Units:
RV Pads
Tent Sites
Single Cabins
Duplex Cabins
Park Model/Modulars
Lodge Units
Other
Type of Clientele, check and give percent of each:
Residential (annual)	%
Seasonal (monthly)	%
Vacation (weekly/daily)	%
Account Information
Description	Estimated Annual Revenue
General Store	$
Liquor	$
Restaurant (What % of sales from non-camping guests?)	$ %
Snack Bar	$
LP Gas	$
Gasoline	$
Laundry	$
RV or Travel Trailer Storage	$
RV or Travel Trailer Sales & Service	$
Special Events: weddings, reunions, etc.	$
Activities
Activities Conducted	# of Units Revenues
Bicycles	$
Canoes	$
Float Tubes	$
Go-Karts	$
Gun/Archery Range	$
Hay, Sleigh or Wagon Rides	$
Horseback Riding	$
Miniature Golf	$
Playground	$
Tennis/ Ball Court	$
Trampolines	$
Water Skiing	$
Waverunners and Jet Skis	$
Hobby Shops or Classes explain:	$
What recreational and sporting activities, other than those listed above, are conducted or take place at your park/resort?
Pool and Swimming Areas
How many of each: Pools Lakes Other (Describe:)
Are your swimming facilities open to the general public?	Yes No
Fenced?	Yes No
Diving Board?	Yes No
Locking Gate?	Yes No
Is the depth of pool marked?	Yes No
Are life rings or buoys provided?	Yes No
Life Guard on Duty?	Yes No
Pool Rules posted?	Yes No
Is a trained employee available for emergencies?	Yes No
Do you have a waterslide?	Yes No
If yes, what is the length and height of slide? Length Height
Watercraft information
What type of operation do you have?
If "Other", describe
On what bodies of water does use take place?
If Rivers, what classes are boated:
Are life vests (PFD's) required?	Yes No
Are life vests (PFD's) provided?	Yes No
Boat Schedule
Boat 1 Info:
Year
Make & Model
Length
Engine Horsepower & Type
Number of Passengers
Guided	Yes No
Boat 2 Info:
Year
Make & Model
Length
Engine Horsepower & Type
Number of Passengers
Guided	Yes No
Boat 3 Info:
Year
Make & Model
Length
Engine Horsepower & Type
Number of Passengers
Guided	Yes No
Canoe and/or Kayak Touring information
Maximum number of boats rented on the same day?
Average number of boats rented on the same day?
What percent of your operations are unguided?
Number of guides?
LP Gas Distribution-FILL Station
Do you have documentation that LP Fill Station meets all state and local codes for training, equipment etc.?	Yes No
Are employees certified and trained to fill LP gas tanks?	Yes No
Is fill station fenced or secured?	Yes No
How many fixed LP Gas tanks do you have on premise?
What is the gallon capacity of each tank?