EventInsurance. One Off Event. Proposal Form. providing cover for all your events...

Transcription

1 One Off Event Proposal Form EventInsurance tel fax web providing cover for all your events... Event Insurance Services Ltd Event House 20A Headlands Business Park Ringwood Hampshire BH24 3PB

2 Section One Public Liability Insurance Section Two Employers Liability Section Three Property Cover Section Four Cancellation Additional Covers This protects your legal liability to pay for compensation and claimants costs and legal expenses following accidental bodily injury or damage to the venue occurring in connection with your event. The cover should be based on the total number of visitors expected to attend throughout the whole event. The level of cover is dependent upon the venues requirements and / or your own personal preference. This protects your legal liability to pay for compensation, claimants costs and legal expenses following accidental bodily injury to anyone you employ at an event, including temporary staff, volunteers or helpers, whether paid or unpaid. This protects your legal liabilities in respect of accidental loss or damage to property either owned by you or for which you are legally responsible, both at the venue and in transit to and from the venue during the period of insurance. Cover for the irrecoverable costs if your event has to be cancelled, abandoned, postponed, interrupted or relocated due to any cause beyond your control, or the control of any other party essential to the fulfilment of your event. Cancellation due to Adverse Weather - Cover for the irrecoverable costs if your event has to be totally cancelled due to adverse weather conditions, defined under the policy as - Such weather conditions which render the fulfilment of the event as being dangerous and irresponsible, having consideration to life and limb of the public attending the event. Cancellation due to Non-Appearance - Cover for the irrecoverable costs if your event has to be totally cancelled due to the non-appearance of a specific individual or group upon whose presence the fulfilment of your event is dependent, for reasons beyond the control of both you and/or the person/s concerned. 2 providing cover for all your events...

3 Please note, this proposal form is specifically for Event Organisers. We do not offer cover for any contractors. If you are unsure as to whether or not we can cover you, please call for further information. Proposer Name: Address: Postcode: Telephone: Fax: Website: Event to be Insured Name of Event: Period of Occupation of Venue (including set up and dismantle) From: To: Dates Open to the Public: From: To: Venue Venue where the principle activities will be held Venue Name: Venue Address: Postcode: Type of Event Please give a detailed outline of the nature of the event, along with details of the activities that you will be arranging at the event. 3

4 ONE OFF EVENT Proposal Form Dangerous Activities The following activities are excluded from cover unless specified and agreed by Us. Any amusement, display, competition or fund raising activity organised by Y o u or on Your behalf or for which Y o u are responsible involving - (i) Fireworks or Bonfires. (ii) Inflatable play equipment. (iii) Fairground rides or mechanical or electrical rides of any kind. (iv) Ballooning or flying of any description. (v) Quad bikes, go-karts or motor sports any kind. (vi) Trampolines, gymnastic apparatus or any apparatus requiring the use of safety harness or ropes to prevent or arrest falls from height. (vii) Circus acts or stunt acts. (viii) It s a knockout competition. (ix) Persons riding on animals. (x) Canoeing, sailing or the use of water rafts. (xi) Shooting ranges for guns or archery. (xii) Trips to theme parks or any beach. (xiii) Pyrotechnical devices. Will there be any other activities that may present a danger to children, participants or spectators? YES NO If YES, please provide full details below and who will be responsible for safety measures? All independent stallholders, exhibitors, contractors or suppliers whom You engage at or allow to stand exhibit or supply services to the Event must be required to hold third party liability insurance in their own right for the duration of the Event, and evidence of the relevant policy, including the name of the Insurer, the policy number and Limit of Indemnity must be recorded by You prior to their participation at the Event. 4 providing cover for all your events...

5 Section One Public Liability Insurance Is Public Liability cover required? YES NO If so, please indicate the level of indemnity required 1 million 2 million 5 million 10 million Estimated Total Attendance What is the Capacity limit of the Venue Estimated Total Attendance per Day Will you employ the services of any independent contractor or company at the Event for: (i) Security YES NO (ii) Professional Catering YES NO (iii) Erection or rigging of temporary stands, seating, tentage, staging or any temporary structures YES NO (iv) Hot work (i.e. work involving the use or application of heat or naked flame) YES NO If YES will they be required to hold Public Liability Insurance in respect of any work they carry out for the Event not less than that requested by YOU above and will they also be required to hold their own Employers Liability Insurance? YES NO Section Two Employers Liability Insurance (This section cannot be covered unless Public Liability cover is also taken out under the policy) Is Employers Liability cover required? YES NO If so, please indicate the level of indemnity required 5 million 10 million Number of Employees Wage Roll and Payments Clerical / Admin. Casual Labour All other employees and labour only sub contractors Unpaid Volunteers / Helpers Will any employees be carrying out height work in YES NO excess of 2.5 metres? If so, please specify below: Will any employees / volunteers YES NO be operating machinery / power tools? 5

6 Section Three Property Cover Is Property cover required? YES NO Total Value of property to be Insured Will 24-Hour Security be in place? YES NO Please provide a breakdown of all property which you own or for which you are legally responsible. MAXIMUM HIGHEST SINGLE ITEM VALUE MARQUEES AND TENTS TABLES, CHAIRS ETC OTHER CONTENTS GENERATORS AND POWER PORTABLE TOILETS PA SYSTEMS PLASMA SCREENS PLANT / MACHINERY BARRIERS / CROWD CONTROL STAGING AND SEATING HEATING / LIGHTING ETC 2 WAY RADIOS BAR / CATERING AUDIO / VISUAL EQUIPMENT OTHER (Please provide a separate list) Dates Equipment on Site: From: To: Important For events in excess of one day s duration, cover is subject to 24-hour security. 6 providing cover for all your events...

7 Section Four Cancellation Cover Is cancellation cover required? YES NO BUDGETED EXPENSES: Please provide a breakdown of your expenses EVENT COSTS VENUE HIRE MARQUEES / TENTS TOILET HIRE SECURITY POWER STAGE AND SEATING LABOUR COSTS MANAGEMENT COSTS AUDIO / VISUAL BARRIERS / CROWD CONTROL TRAVEL / ACCOMMODATION ADVERTISING MISCELLANEOUS OTHER Adverse Weather Please Note: Adverse weather cover is defined as: Is cover required in respect of adverse weather? YES NO (This cover is subject to 14 days notice) Such weather conditions which render the fulfilment of the event as being dangerous and irresponsible, having consideration to life and limb of the public attending the event. Non-Appearance Risk Will the non-appearance of any key performer, entertainer or other persons cause cancellation or abandonment of the event? YES NO Is cover required for their non-appearance? YES NO If Yes, please specify who could cause cancellation of the event. If so, is there a written contract for their appearance? YES NO Key Performer or Entertainer Please provide details for each Key Performer or Entertainer including details of: AGE OF PERFORMER / ENTERTAINER HEALTH OF PERFORMER / ENTERTAINER TRAVELLING FROM? METHOD OF TRANSPORT BEING USED? HOW LONG AHEAD OF THEIR PERFORMANCE WILL THEY BE ARRIVING? 7

8 Event Policy General Questions 1. Whilst organising or participating in an event, have you, any official, committee member or co-organiser: a) Sustained any loss or damage or liability during the last 5 years, whether insured or not? b)had any insurance declined or cancelled or special terms imposed? 2. Have you, any official, committee member or co-organiser ever been convicted or charged but not yet tried for an offence other than a driving offence? If yes, please provide full details. YES YES YES NO NO NO 3. a) Will adequate first aid be provided? b) If so will suitably qualified staff be in attendance? 4. Has the permission of the local authority been sought and granted? 5.a) Has the advice of the police or fire authority been sought? b) Will either be present at the staging of the event? 6.a) Will staging and seating be erected? b) If so will this be carried out by suitably qualified professionals with their own insurance? 7. If the event is staged over a number of days, has 24 hour security of the site been arranged? Declaration To the best of my knowledge and belief, the information provided in connection with this proposal, whether in my own hand or not, is true and I have not withheld any material facts. I understand that non-disclosure or misrepresentation of a material fact will entitle Underwriters to void this insurance. (A material fact is only likely to influence acceptance or assessment of this proposal by Underwriters. If you are in any doubt as to whether a fact is material or not, please disclose it on a separate attached sheet). I understand that the signing of this proposal does not bind me to complete the insurance but agree that, should a contract of insurance be concluded, this proposal and statements made therein shall form the basis of the contract. Signatures of all Proposers: Date: 8