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Home > Self Insurance > Special Events > Complete a Receipt
Special Events Program:
How to Complete a Special Events Coverage Receipt

When the promoter of an interim event planned for your fairgrounds needs liability coverage, offer them Special Events coverage provided by California Fair Services Authority (CFSA). Our rates are competitive and you can't beat the convenience - you can sign them up at your fair, right on the spot.

Remember, if the covered special events operator is going to have separate exhibitors, a security company or anyone else in addition to themselves, the operator must require proof of liability insurance from each attending person or group.

How to Fill Out a "Coverage Receipt"
If you run low on pre-printed forms, feel free to print out copies of the "Coverage Receipt" and the Evidence of Coverage (for the lessee). You'll need Adobe Acrobat Reader to access and print the forms; download it for free from the Adobe Web site.

For now, this form cannot be completed online. If you'd like to be able to fill it out on your computer, contact Lianne Lewellen and she'll mail you the form on disk. She's also available to answer any questions you may have and to replenish your supply of pre-printed forms if you're running low.

To fill out the Special Events coverage receipt:

1. Determine the coverage rate from the Special Events Rate Card* here or in your Red Book (Claims and Loss Reporting Guide), under General Liability, Tab 4. You can also call Lianne Lewellen at CFSA, (916) 263-6145, during regular business hours for immediate information about special rates, classifications, or if you have a question.

*You'll need Adobe Acrobat Reader to access the Rate Card. If you don't already have it on your computer, you can download it for free from the Adobe Web site, www.adobe.com

2. Collect the required fee from the lessee in the form of a money order, cashier's check or certified check only, payable to CFSA. Business or personal checks cannot be accepted and will be returned to the fair.

3. Issue copy 1 (white) of the "Special Events Coverage Receipt" to the lessee. An Evidence of Coverage is on the reverse side of this copy for the lessee's information.

4. Attach copy 2 (canary yellow) to your fair's copy of the contract or rental agreement as proof of coverage.

5. Send payment along with copies 3 and 4 (pink and goldenrod) of the Receipt to reach CFSA no later than five days prior to the covered event. Late payments should be called in to Lianne Lewellen, (916) 263-6145, for a Control Number.

Send your Receipt(s) to:
California Fair Services Authority
Attn: Special Events
1776 Tribute Road, Suite 100
Sacramento, CA 95815

6. CFSA will stamp copy 4 (goldenrod) with the date it was received and return it to your fair for your records.

In addition -

  • At the end of each quarter, a processing reimbursement of 5 percent of your net receipts collected will be returned to you by CFSA's Accounting Department. This reimbursement is designed to help cover staff time spent promoting the coverage and handling the paperwork.
  • Requests from fairs for refunds on cancelled events will be refunded directly to the lessees. No refunds will be made to fairs.
  • If a processing fee is charged to the vendor by the fair for participating in this program, said fee must be disclosed as a separate charge. This procedure is discouraged, as it tends to make our rates non-competitive.

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