Broker / Agent Login

** Due to high volume, we are experiencing longer than normal quote turnaround. **
If your event is within 7 business days this will be pushed through as a RUSH quote.
All Event submissions WILL receive a quotation prior to their event start date.





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Contact Information

Amanda Erdelac

1-800-265-8098 ext. 231

amanda.erdelac@palcanada.com

My regular office hours are Monday- Friday, 8:30 am to 4:30 pm Eastern Time

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WHAT IS GOLF PUTT?

  • Up to 10 participants can have a chance to Putt for a Hole in One
  • Great promotional opportunity, for Companies, Golf Courses, Sponsors, etc.
  • Premiums as low as $75.00
  • Automatic quote, bind and issue for submissions up to $50,000. Higher limits available for over $50,000 will be reviewed once submitted.
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Rating Details

  • Rating available from 1 - 10 participants
  • Rating available for a minimum 60 ft
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FOR ALL OTHER GENERAL PRIZE INDEMNITY

  • Hole in One
  • Hockey Scoro ( shoot a puck from the far blue line ( 114 ft) into a target opening ( 3.5 inches by 1.5 inches).
  • Rapid Fire ( 20 pucks are shot into an open net within 20 seconds), Curling, Basketball, Crack the Code, Envelope Draw, etc. **

** For these contests and others please go to our Prize Indemnity page and submit a manual application.




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Section 1

Reference #
82-529


Location Province: * 
 
Number of Participants: * 
 
Golf Putt minimum distance (in feet): * 
 
Prize value: * 
 
Are there any professional golfers?: * 
               
Please confirm: Contestants may not attempt any practice or warm-up putts in any manner from any distance prior to their attempt once they have been notified as a grand prize finalist.: * 
               
Please confirm: If selected through a qualifying round, contestants may not have attempted any qualifying putt from a distance of greater than 10 feet.: * 
               
Please confirm: No two (2) consecutive putt attempts may be initiated from the same location on the green. Each consecutive putt attempt must be initiated a minimum distance of 10 feet apart: * 
               
Please confirm: The putting contest will take place on a real ( grass only) green?: * 
               
Subject to the terms and conditions of this Golf Putt program, all golf putts will be video taped by an official camera operator.: * 
               

Section 2

Name of insured: * 
   
Address: * 
   
City: * 
   
Province: * 
 
Postal Code: * 
   
Phone Number: * 
   
Email: * 
   

Section 3

Contest Name: 
   
Date: * 
 
Golf Course Name: * 
   
Course Address: * 
   
City: * 
   
Postal Code: * 
   
Name of Course Pro Manager: * 
   
Golf Putt - Terms and Conditions
I have read and agree to the above terms and conditions: * 
        

Section 4

Name of person completing this form: * 
   
Mailing Address of person completing form: * 
   
City: * 
   
Province: * 
 
Postal Code: * 
   
Phone Number: * 
   
Email: * 
   
Verify Email: * 
   
Application and full payment must be submitted at least 1 hour (minimum) prior to the tournament/contest start time.

Section 5

I /We hereby declare that the answers and declarations above, whether in my own hand or not, are true and that I /we warrant that no material fact has been withheld or misstated and agree that this proposal will form part of the policy and will form the basis of the contract with underwriters. I /we understand that the underwriters may declare any policy issued void in the event of any false statement, misrepresentation, omission or concealment whether made intentionally, innocently or accidentally. For purposes of the Insurance Companies Act (Canada), this document was issued in the course of Lloyd's Underwriters' insurance business in Canada
I/we agree: * 
        
I have reviewed the information above and have ensured it is 100% accurate.
Check to confirm: * 
        
How did you hear about us?: 
 
If other, please specify: 
   
   

HELPFUL INFORMATION
Here are a few things to try to get your certificate successfully:
  1. Check the screen for any error messages. They will appear in red above the location of the error.
  2. Double check your information to make sure it has been entered correctly.
  3. You can always start over from scratch if you are having issues.
  4. You may want to try a different browser. Sometimes the settings of a certain browser may cause a problem and using a different browser will allow you to complete your submission.

 

CUSTOMER SERVICE
E-mail:  ontario@palcanada.com
Phone: 1-800-265-8098
Hours: Ontario 8:30am to 4:30pm EST Alberta 8:30am to 4:30pm MST

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