Minor League Baseball

MINOR LEAGUE BASEBALL

INSURANCE QUESTIONNAIRE

• NOTE: This questionnaire is to be submitted along with the following completed forms:
• ACORD Applicant Information application 125
• ACORD Commercial General Liability Section 126
• ACORD Applications for other requested coverages: Property; Garage; Crime; Inland Marine; Transportation; Excess Liability; Employment Related Practices.

GENERAL INFORMATION
1. Name of Insured (Applicant):
2. What is the insured’s FEIN number?
3. Team Name: / League:
UNDERWRITING INFORMATION
4.What is the estimated turnstile attendance for the upcoming season?
5.What was the turnstile attendance for the last three years:
6.Please provide breakdown for the following categories:
a.Game Receipts$
b.Concession Receipts$
i.Food and drink$
ii.Liquor$
iii.Merchandise$
c.Parking Receipts$
7.Do entities using the facility list the proposed named insured as an additional insured (if team owns or manages their stadium? Yes No
If yes, what limit is required?
8.Who has authority to sign contracts on behalf of the proposed named insured and what is the review process?
9.Does the team have a procedure for securing certificates of insurance from all sub-contractors and service providers? Yes No
If yes, are the certificates reviewed for minimum requirements? Yes No
If yes, please provide an outline of the minimum requirements.
Do they name the team as additional insured? Yes No
10.For instances where subcontractors are utilized, is the proposed named insured listed as an additional insured under the subcontractor’s policy? Yes No
11.A copy of the uniform player agreement is required if the team participates in an independent League.
12. For Stop Gap coverage, please provide the payroll for the monopolistic states (OH, WA, ND, WV, WY)
OH / WA / ND / WV / WY
13. Do you have a written set of guidelines governing mascot behavior? Yes No
If yes, please provide a copy of the mascot behavior guidelines.

CONTRACTUAL UNDERWRITING INFORMATION

14. Details of written contractual agreements other than liability assumed under any lease of premises, easement agreement, agreement required by municipal ordinance, sidetrack agreements, and elevator or escalator
maintenance agreement:

MEDICAL UNDERWRITING INFORMATION

(Please complete this section if the insured desires to include Athletic Trainers coverage)

15. Name of team doctor:
16. Is the doctor an employee or an independent contractor?
17. Are the team trainers employees or independent contractors?
18. Are all the team trainers certified by the National Athletic Trainers Association? Yes No
If no, please explain other certification:
19. Do those trainers certified by the National Athletic Trainers Association purchase professional liability coverage provided through NATA? Yes No
20. For game day, is an ambulance/medical service available at the facility for treatment of injured players?
Yes No
If yes, is the ambulance/medical service staff ALS certified? Yes No

PARTICIPANT LIABILITY

21.Are any of your players independent contractors or not covered by Workers’ Compensation? Yes No
22.Do you require a waiver and release to be signed by all participants not protected by Workers’ Compensation? (e.g. free agent tryout, cheerleader, mascot) Yes No
If yes, attach a copy.
PROFESSIONAL LIABILITY
23. Do you have any employed broadcasters? Yes No
If yes, describe the exposure:
24.Describe any publishing exposures:

EMERGENCY PLANNING

25.Describe any loss control procedures or safety programs in place:
26.Are you responsible for crowd control? Yes No
27.Provide a copy of the Emergency Plan.

GAME DAY OPERATIONS

(Please provide a schedule of practices, games, and all other ancillary events for the proposed policy period.)

Specify who has responsibility for the following game day operations (check one):
Activity / Team / Facility / Subcontractor / Specify Company Contracted
Participants
Spectators
Security
Parking
Concessions-Non-Alcohol
Concessions-Alcohol
Facility Maintenance
Maintenance of Competition Area
First Aid
Fireworks
(If team holds contract with pyrotechnician or puts on its own firework displays, please complete Pyrotechnics Section of this application)
28.Person responsible for general operation of facility activities:
Years of experience:
29.Any self-promoted events? Yes No
If yes, please describe:
30.Date stadium/venue was constructed: / Date of any major reconstruction:
Primary construction material(s): / Stadium/venue capacity:
Permanent seating capacity: / Type of siren/smoke alarms:
31.Are there any amusement rides, air inflatable structures, rock climbing walls, playground equipment, pools or hot tubs, etc. on premises or brought on premises temporarily? Yes No
If yes, please describe:
32.Any childcare services provided? Yes No
If yes, please describe:
OTHER ACTIVITIES
33.Does the team conduct clinics or camps? Yes No
If yes, how many conducted/estimated attendance?
34. Will the team conduct any other special events, either during or after games such as concerts? Yes No
If yes, please explain type and number:
Does the team collect certificates of insurance from the performers? Yes No
Is the team listed as Additional Insured on the certificate? Yes No
A.ABUSE AND MOLESTATION
(Please complete this section if you need a quote for Abuse and Molestation Coverage. If you do not need a quote for Abuse and Molestation Coverage please skip this section and continue to the next section.)
35.Does the insured have custodial responsibility for minors? Yes No
If yes, is abuse coverage desired? Yes No
36. Do your employees and volunteers (paid and volunteer) employment application include questions about whether the individual has ever been convicted for any crime, including sex-related or child-abuse offenses?
Yes No
If yes, what is the process for dealing with a "yes" answer?
37.(a)Does your state permit you to do criminal background checks on:
Yes No Employees?
Yes NoVolunteers?
(b)If yes, do you routinely request and receive such background information on all individuals who will have contact with minors? Yes No
38.(a)Do you verify employment-related references for employees? Yes No
(b)Do you verify employment-related references for volunteers? Yes No
39.(a)Do you conduct a personal interview for employees? Yes No
(b)Do you conduct a personal interview for volunteers? Yes No
40.Do you have a written set of procedures for screening employees and volunteers? Yes No
If yes, please forward. If no, please describe your screening process.
41.Do you have an Abuse / Molestation Policy with regard to sexual abuse? Yes No
If yes, please indicate how it is provided to your employees/volunteers.
42.Do you have written procedures for dealing with allegations of sexual abuse? Yes No
If yes, please forward. If no, please describe what your current response would be.
43. Describe how your organization supervises employees and volunteers having custody of children.
44.(a) Has your organization ever had an incident which resulted in an allegation of sexual abuse? Yes No
If yes, please describe your organization's response to the allegation.
(b) Was a claim made against the organization or an individual within the organization? Yes No
When did the alleged incident(s) occur?
(c) Was the case taken to trial? Yes No / Civil Criminal
(d) What was the disposition of the case?
45.Regarding coverage for abuse and molestation, does your current insurance program:
Yes NoExclude coverage?
Yes NoLimit coverage (please forward a copy of the endorsement)?
Yes NoNeither exclude nor limit coverage?
46.Please indicate age range of minors in your care or under the supervision of your employees or volunteers at any time.
47.Please describe your current and/or planned operations that involve the custodial care of minors.

B.EMPLOYEE BENEFITS LIABILITY

(Please complete this section if you need a quote for Employee Benefits Liability Coverage. If you do not need a quote for Employee Benefits Liability, please skip this section and continue to the next section.)

48.Does applicant have a full-time Personnel Department? Yes No
49.Number of employees under Employee Benefit Program administered in the U.S. or Canada:
50.Employee Benefit Programs which are automatically covered without being specifically listed by the applicant are (check all that apply):
Group Life Insurance / Group Accident or Health Insurance / Profit Sharing Plans / Pension Plans
Employee Stock Subscription Plans / Workers' Compensation / Unemployment Insurance
Disability Benefits Insurance / Social Security Benefits
51.List below any other types of benefit programs the applicant wants the company to consider for inclusion under this insurance:
Type of Benefit Program
52.On programs permitting employees an option to enroll or not to enroll, does the applicant require a signed acceptance or rejection from each employee? Yes No
If yes, is the signed acceptance or rejection retained in the employee's personnel file? Yes No
53.Is a benefit brochure or written explanation of the Employee Benefits Program given to each employee? Yes No
54.Are all benefits available to all employees? Yes No
If no, list all exceptions:
55.Who advises the employees of their benefits?
Personnel Manager / Department Manager / Immediate Supervisor / Other (Please describe):
56.Is there a review of employee questions and a record kept as to each employee's acceptance or rejection of any one or all the benefits? Yes No
57.Has any Error and Omission loss ever been sustained or is any such claim pending against the applicant? / Yes No
If yes, please give details:
58.Has any occurrence taken place in the past that is likely to give rise to a claim? Yes No
If yes, please give details:
59.Number of branches, other business locations:
60.How are employees in branches and other locations advised of benefits?
61.What is the first date any previous Employee Benefits Liability coverage was carried?

C. LIQUOR LIABILITY

(Please complete this section if you need a quote for Liquor Liability Coverage. If you do not need a quote for Liquor Liability, please skip this section and continue to the next section.)

62.Name on liquor license:
63.Liquor license number: / Class of license:
64. Type of facility or event where liquor will be sold:
Dates coverage required:
Opening and closing hours of event(s):
Opening and closing hours of liquor sales:
65.Has applicant's liquor license ever been revoked or suspended? Yes No
If yes, please explain:
66.Has any insurer cancelled or non-renewed coverage during the last 3 years? Yes No
If yes, please explain:
67.Has applicant ever been fined by alcoholic beverage control or other governmental regulator? Yes No
If yes, please explain:
68.Type of beverages sold:
69.Are patrons allowed to carry alcoholic beverages onto the premises?Yes No
If yes, what type?
70.Do you exercise the right of search and seizure of contraband items? Yes No
If yes, how do you notify the public of this?
71.Do you maintain security personnel at entry check points? Yes No
If yes, what type?
Are the alcohol sales and consumption: Contained within one fixed site, or Are booths/stands located throughout the event site?
72.Number of servers used?
Professional? Yes No Explain:
Volunteer? Yes No Explain:
73.Do the servers receive any type of alcohol awareness training? Yes No
If yes, please explain:
(attach training manuals used)
74.Median age of liquor customers: 21-25 25-30 30-40 40 and over
Are minors allowed to enter the location where alcohol is being served? Yes No
If yes, how is underage consumption of alcohol prevented?
75.Explain how ID's are checked:
76.Are rules and regulations clearly displayed for patrons viewing? Yes No
77.Are uniformed police officers present at the site of alcohol sales? Yes No
If yes, how many?
Are undercover police officers present? Yes No
If yes, how many?
Are private security officers present? Yes No
If yes, how many?
78.In what size of container is the alcoholic beverage served? Cup oz. Pitcher
Other
79.Is there a limit placed on the quantity of alcoholic beverages purchased at one time? Yes No
Explain:
80. Is there entertainment provided? Yes No
Live music? Yes No
Disc Jockey? Yes No
Type of music:
81.Is the parking area patrolled to prevent intoxicated drivers from leaving the premises? Yes No
Explain:
82.Is there any type of designated driver program? Yes No
Explain:
83.Is there any other underlying liquor liability coverage being provided? Yes No
Explain:

D.PYROTECHNICS

(Please complete this section if you need a quote for Pyrotechnics Coverage (scoreboard fireworks, etc.). If you do not need a quote for Pyrotechnics, pleaseskip this section and continue to the next section.)

84.Who will be the pyrotechnics operator?: Named Insured Contractor
85. Description of Events:
86. Location of Events:
Street / City / State / Zip
87. Dates of Events:
88.Who is the Authority having jurisdiction over the use of pyrotechnics at your facility?
Local Fire Department State Fire Marshal Other (please list):
89.What permit process must be followed prior to use of pyrotechnics at your facility:
90.Have you staged pyrotechnic displays before? Yes No
Complete this section if thePyrotechnics Operator is the Named Insured
Describe the type and amount of pyrotechnics used in recurring events (e.g. facility introductions, home runs, etc.):
Describe what fire prevention and suppression measures are taken to support the pyrotechnic loading and firing
process:
Do you secure proper pyrotechnic permits for each event? Yes No
Complete this section if thePyrotechnics Operator is a Contractor.
(a)Name:
(b)Is there an agreement with the contractor? Yes No
(c)Will liability coverage be provided by the pyrotechnics contractor? Yes No
If yes, please indicate limits of coverage provided:
$1,000,000 Greater than $1,000,000 Other:
(d)Do you confirm that the contractor has secured the proper pyrotechnic permits for each event? Yes No
(e) Describe what fire prevention and suppression measures are taken to support the pyrotechnic loading and firing process:
(6)91. Do you allow tenant users (including temporary tenant users) to conduct pyrotechnic displays either themselves or through a contractor? Yes No
92. Does the tenant lease/user agreement indicate that pyrotechnic displays are not permitted? Yes No
93. Are events with pyrotechnics held: Indoors Outdoors
94. What type of pyrotechnics will be displayed (as defined in NFPA code 1126)?
Aerial Shells Airbursts Black Powder Comets
Concussion Effects Concussion Mortars Electric Matches Flares
Flash Pots Flashpowder Gerbs Integral Mortars
Mines Mortars Rockets Saxons
Waterfall, Falls, Park Curtains Wheels Salutes
Other, please list:
OUTDOOR PYROTECHNICS (only complete if outdoor pyrotechnic displays are staged)
95.Are the events in compliance with NFPA 1123 or 1126 (Code for Fireworks Display)? Yes No
96.Is there fencing to keep spectators away from restricted areas during the fireworks shooting? Yes No
If yes, distance of spectator fencing from launch site:
Distance of spectator parking area from launch site:
Distance of closest building or structure from launch site:
97.Will there be firefighting equipment on site during the event? Yes No
98.If no firefighting equipment on site, give distance to nearest fire station:
99.Will you have an ambulance on site? Yes No
If no,(a) what is the estimated response time of an ambulance?
(b) distance to nearest medical facility:

E.SECURITY COVERAGE

(Complete only if security is the responsibility of the insured)

PART I
100.Who is primarily responsible (via contract) for liability coverage for security personnel?
Insured Municipality Subcontractor
Number of security officers:
101.Do any security personnel carry a firearm as part of their equipment while on duty? Yes No
If yes, number of armed security personnel:
102.Are the security persons employed or contracted by the park? Employed Contracted
("Employed" means the individual is being paid and supervised directly by the insured. "Contract" means the existence of a written contract with another entity for security services that has insurance coverage separate from the insured's policy for security liability.)
Note:If "Employed," please answer Section E., Part I, II, III, and V.
If "Contracted," please answer Section E., Part I, II, III, IV, and V.
103.What are the staffing guidelines per number of patrons?
104.Are the guidelines determined by: Ordinance, or Statute?
Industry standard? Yes No
Other (please describe):
PART II:
105.Is there a pre-employment screening procedure? Yes No
If yes, please describe:
106.Does the procedure include contacting previous employers over the previous five years? Yes No
107.Do you contact at least three personal references? Yes No
108.Is a criminal background check made? Yes No
If "yes," what agency is used for the criminal background check?
109.Is completion of a minimum 20 hours initial training program required before deployment? Yes No
110.Who conducts the training and what are the trainers qualifications:
111.Is a minimum of 10 hours on-site training required? Yes No
112.Is a minimum of 4 hours of annual refresher or continuing education training planned and conducted for each
security employee? Yes No
113.Is each security person given a personal copy of the training/safety manual? Yes No
If "yes," has each security person given the park written acknowledgment of the policies and contents?
Yes No
PART III:
114.Are the security personnel in uniform? Yes No
If "no," please describe how they are identified:
115.Please indicate any equipment carried or routinely available to security personnel:
Flashlight
HandcuffsNight Stick (Is Night Stick Police Regulation? Or Other?)
First Aid Kit (including blood borne pathogen kit)
Taser/PhaserChemicals (Mace, pepper gas)
Other:
Firearm - Caliber:.357.38.9mmOther:
Make:ColtS&WRugerOther:
Covered HolsterType:
Is AmmunitionStandardOther:
Firearm and ammunition approved and inspected by park or security company? Yes No
116.Describe capabilities of each guard for constant communications with each other, the supervisor, and park
management:
117.Are dogs used in your security operations? Yes No
If yes, please provide the type of dog(s), number, and describe duties.
PART IV:
118.Date the contracting company began business:
119. Is there a written agreement with contracting company? Yes No
If "yes", please enclose a complete copy of the written agreement.
120. Name of contracting company's liability insurance carrier.
121.Is there an established working relationship with local law enforcement? Yes No
If "yes," please describe:
122.Is there a procedure to immediately report all incidents to park? Yes No
If yes, please describe:
PART V:
123.Does the supervisor make personal contact with each security person at least once during each shift?
Yes No

H.HOT TUBLIABILITY