ARCHITECTS PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM

Transcription

1 ARCHITECTS PROFESSIONAL INDEMNITY INSURANCE PROPOSAL FORM

2 Please read the fllwing infrmatin carefully befre cmpleting this prpsal frm. This shuld help present a clear and unambiguus picture and t ensure that underwriters understand the nature f yur risk: An Individual r a Partner, Principal r Directr f the Firm/Cmpany must cmplete the prpsal frm. Where a questin is nt applicable t yur particular circumstances, please write N/A If there is insufficient space t answer questins please use an additinal sheet and attach it t this prpsal frm Cmpleting and signing this prpsal frm des nt bind yu, r insurers, t cmplete this cntract f insurance, If this prpsal relates t a new business r venture, please cmplete the questins as far as pssible, giving estimated incme and infrmatin abut yur anticipated activities 1 Name and address f Insured Firm(s) including any predecessrs in business: Pstde firm established: 2 Please prvide a full descriptin f the business carried ut by the Insured Firm(s) 3 Is the Firm Assciated with any ther Firm(s)? Yes N If Yes please give full details 4 In respect f all Principals, Partners r Directrs please prvide the fllwing details: Name Qualificatins Qualified Number f years at firm Architects Prfessinal Indemnity Insurance Prpsal Frm Page 2 f 9

3 5 Please prvide details f staff numbers Emplyees Cnsultants Administrative & Others Ttal 6 If a sle practitiner, please give details f the Prfessinal cver arranged in the event f hliday r sickness 7 Please state the grss fee incme received fr each f the last three financial years plus an estimate fr the next financial year Last Year Current Year Next 12 mnths Grss fee 8 (a) Please prvide details f the 3 largest cntracts undertaken in the last 3 years: Client name and type Type f wrk Cntract value Perid (b) Please prvide details f the 3 largest cntracts undertaken in the last 3 years: Client name and type Type f wrk Cntract value Perid Architects Prfessinal Indemnity Insurance Prpsal Frm Page 3 f 9

4 9 (a) Please prvide percentage split f the types f cntracts undertaken and/r cmmenced in the last 12 mnths: Husing Cmmercial and/r Offices High Rise Buildings (abve 10 flrs) Schls r Municipal Buildings Hspitals Htels / Pubs Any Other Leisure, Sprt r Amusement Industrial Systems Building Harburs, Jetties, Dams r Offshre Installatins Mines, Tunnels, Nuclear, Petr Chemical, Oil r Gas Installatins Rads, Highways r Rad Bridges Railways/Airprts (safety critical) Glf Curses Swimming pls Other (PLEASE SPECIFY) (b) Please prvide percentage split f the types f cntracts undertaken and/r cmmenced in the last 12 mnths: Architectural Cncept Design Only (A-C / 0-2 services nly) Architectural full services (A-L / 0-7) excluding incme frm abve Abrted Wrk Building Surveying Engineering Expert Witness Wrk Feasibility Wrk Interir Design (nn-structural) Interir Design (structural) Landscape Architecture Land Surveying Planning Supervisin Prject C-rdinatin Prject Management Quantity Surveying Structural Survey Wrk Twn Planning Architects Prfessinal Indemnity Insurance Prpsal Frm Page 4 f 9

5 10 D yu r have yu ever undertaken any wrk verseas? Yes N If s, PLEASE SPECIFY belw: Cuntry Type f wrk Ttal cntract value Perid 11 Have yu been invlved in any specialist cntracts fr Cladding, Curtain Walling, Glazing, Rfing and/r Water Schemes? Yes N If s, PLEASE SPECIFY belw: 12 Has any Insurer ever declined t ffer terms, impsed special terms r cancelled r vided any Insurance fr the Insured Firm(s) r any Principal, Partner r Directr? Yes N If Yes please prvide full details: 13 Have any claims and/r circumstances ever been made against the Insured Firm(s) r its predecessrs r any past r present Principal, Partner, Directr r Emplyee whether successful r nt? Yes N If Yes please prvide full details: Architects Prfessinal Indemnity Insurance Prpsal Frm Page 5 f 9

6 14 Are yu r any f the Principals, Partners r Directrs r emplyees AFTER FULL ENQUIRY aware f any circumstances which may give rise t a claim against the Insured Firm(s) r its predecessrs r any past r present Principal, Partner, Directr r Emplyee? Yes N If Yes please prvide full details: 15 D all partners/directrs have at least five years experience r the relevant prfessinal qualificatins? Yes N 16 Des the Prpser use cnditins f cntract in every case? Yes N 17 Des the Prpser/Insured wrk t a Prfessinal Cde f practice? Yes N 18 Is the Prpser/Insured accredited t r in the prcess f becming accredited t BS EN ISO 9001 (frmerly ISO 9000 and/r BS5750) Quality Systems r subject t any ther frm f external assessment? Yes N 19 Prir t cntracts being accepted des the Prpser/Insured check cntract specificatins can be met and custmer requirements can be satisfied by ensuring they have the technical ability t undertake the cntract, the resurces and time? Yes N Architects Prfessinal Indemnity Insurance Prpsal Frm Page 6 f 9

7 Duty f Disclsure Euna Underwriting wuld like t remind yu f the duty f plicyhlders and intermediaries t pass n the Underwriter(s), all material infrmatin relating t the risk under cnsideratin. Material in this cntext refers t all infrmatin which a prudent Underwriter (nt necessarily the Underwriter in questin), wuld wish t take accunt f when cnsidering whether r nt t accept the risk, and if s, upn what terms and at what price. Material infrmatin des nt necessarily have t increase the risk. The duty f disclsure cntinues up until the Insurance has been cncluded and resurrects in the event f any amendment t the risk during the plicy perid r any extensin/renewal. It may als be that the terms f the plicy include specific nging disclsure cnditins r warranties which effectively extend the duty f disclsure pst inceptin f the plicy. In the event that there is a breach f the duty f disclsure, the Underwriter has the right t avid the Insurance frm its cmmencement. Under such circumstances, the Underwriter(s) wuld be entitled t seek recvery f any claims already paid by them under the Insurance, althugh at the same time the Underwriter(s) wuld generally be bliged t return paid premium (in the absence f dishnest cnduct). Declaratin It is declared that t the best f the knwledge and belief f the insured the statements and replies set ur herein are true and that n material facts have been misstated r suppressed after enquiry. The insured undertake t infrm insurers f alteratins t any facts which are r thereby becme material befre inceptin f the cntract f insurance. A material fact is ne which wuld influence the acceptance r assessment f the risk. OR I the undersigned authrized fficer f the cmpany declare that t the best f my knwledge and belief that the statements set frth herein are true I the undersigned authrized fficer f the cmpany declare that t the best f my knwledge and belief that the statements set frth herein are true Signed: Print name: d: Psitin: Cmpany: Architects Prfessinal Indemnity Insurance Prpsal Frm Page 7 f 9

8 Duty f Disclsure Euna Underwriting wuld like t remind yu f the duty f plicyhlders and intermediaries t pass n the Underwriter(s), all material infrmatin relating t the risk under cnsideratin. Material in this cntext refers t all infrmatin which a prudent Underwriter (nt necessarily the Underwriter in questin), wuld wish t take accunt f when cnsidering whether r nt t accept the risk, and if s, upn what terms and at what price. Material infrmatin des nt necessarily have t increase the risk. The duty f disclsure cntinues up until the Insurance has been cncluded and resurrects in the event f any amendment t the risk during the plicy perid r any extensin/renewal. It may als be that the terms f the plicy include specific nging disclsure cnditins r warranties which effectively extend the duty f disclsure pst inceptin f the plicy. In the event that there is a breach f the duty f disclsure, the Underwriter has the right t avid the Insurance frm its cmmencement. Under such circumstances, the Underwriter(s) wuld be entitled t seek recvery f any claims already paid by them under the Insurance, althugh at the same time the Underwriter(s) wuld generally be bliged t return paid premium (in the absence f dishnest cnduct). Declaratin It is declared that t the best f the knwledge and belief f the insured the statements and replies set ur herein are true and that n material facts have been misstated r suppressed after enquiry. The insured undertake t infrm insurers f alteratins t any facts which are r thereby becme material befre inceptin f the cntract f insurance. A material fact is ne which wuld influence the acceptance r assessment f the risk. I the undersigned authrised fficer f the cmpany declare that t the best f my knwledge and belief that the statements set frth herein are true Signed Print Name Psitin Cmpany Checklist fr cmpleted prpsal frm This srt checklist shuld ensure that yu have cmpleted the mst imprtant parts f the prpsal frm crrectly. Questin 1 Name f Insured Firm(s) Have yu entered all f the firms names that require cverage? This shuld include, but nt be limited t, past trading titles r businesses yu may have acquired. Questin 2 Qualificatins / Experience If any f the principals, partners r directrs d nt have either an industry recgnized qualificatin and/r have been at the firm fr less than 3 years please prvide an apprpriate CV Questin 6 Breakdwn f Wrk Disciplines The percentage breakdwn f yur wrk disciplines must add up t 100. If any f yur wrk activities fall utside f the stated wrk disciplines please prvide details separately under ther. Questin 29 Claims Details It is vitally imprtant that all knwn claim and/r circumstances that might give rise t a claim are disclsed. This includes any matters pertaining t predecessr r assciated firms. Architects Prfessinal Indemnity Insurance Prpsal Frm Page 8 f 9

9 Euna Underwriting Limited America Huse, 2 America Square Lndn EC3N 2LU Phne: inf@euna.cm Euna.cm Authrised and Regulated by the Financial Cnduct Authrity FRN Registered in England and Wales Number at 5th Flr Minries Huse 2 5 Minries, Lndn EC3N 1BJ Euna Underwriting Limited are an Appinted Representative f ES Risks Limited FRN May 16