Schedule to the Policy 1 Policy Number: SALSALIA/M74221/0330/15 2 Form Number: SJC2010SAUA 3 Insured Name: Ultimate Training Days Ltd & Ultimate TDX Ltd 4 Insured Address: 103 Cranbourne Road, Ashton-under-Lyme, Greater Manchester, OL7 9BW 5 Policy Period: From: 8 February 2015 6 Information provided to Underwriters on: To: 7 February 2016 Both dates Inclusive Local Standard Time at the Insured s address as above stated. 7 January 2015 7 Business: Ultimate Training Days Ltd 1. Abseiling and multi-activity days/weekends. They use only established companies who have their own liability insurance. Employees will go along to assist and take part. 2. Over sea events (Europe only). Walking type activities only. Employees will go along to assist and take part. 3. Self Drive Charity road trips. Employees will go along as guides only. No taking part in the activities. Ultimate TDX Ltd Guided Walks - Groups of up to 50 walkers on guided tours in countryside, rural, mountainous areas (No use of ropes and or tackle). Predominately done all over the UK. 8 Limit of Indemnity: Employers Liability: GBP 10,000,000 Any One Claim, including costs and expenses Public Liability: GBP 5,000,000 Any One Claim, costs and expenses in addition Products Liability: GBP 5,000,000 in the aggregate, costs and expenses in addition 9 Excess: Property Damage GBP 500 10 Premium: Employers Liability: GBP 720.00 for the Policy Period Adjustable on All Other Employees at: 1.5000% Public/Products Liability: GBP 1,400.00 for the Policy Period Adjustable on Turnover at: Ultimate Training Days 0.6000% Adjustable on Turnover at: Ultimate TDX Ltd 0.2000% Insurance Premium Tax: GBP 127.20 Deposit & Total Premium: GBP 2247.20 11 Endorsements: As attached 9 February 2015 Signed on behalf of certain Underwriters at Lloyd s, London Date 1
Schedule to the Policy ENDORSEMENTS The following endorsement attaches to and forms part of Policy Number SALSALIA/M74221/0330/15 in the name of Ultimate Training Days Ltd & Ultimate TDX Ltd :- Excess We shall not indemnify You in respect of the first GBP 500 of all claims (including costs and expenses) arising from Damage to Property. If any amount paid by Us includes the above amount You shall reimburse Us. Premium Payment Warranty It is a condition precedent in respect to liability insurance that the minimum and deposit premium due to SAUA under this insurance is paid to SAUA within 60 days after the effective inception date of the insurance, renewal or adjustment date (as appropriate) of the insurance. Should the premium not be paid within the given period all cover under the insurance will be cancelled and of no further effect and treated as Not Taken Up. Sanction Limitation and Exclusion Clause We shall not provide any benefit under this policy to the extent of providing cover, payment of any Claim or the provision of any benefit where doing so would breach any sanction, prohibition or restriction imposed by law or regulation. Bona Fide Sub Contractors Condition We will not indemnify You under this Insurance in respect of any claim arising out of or in connection with work undertaken on Your behalf by bona fide independent contractors (not defined as a Person Employed under this Insurance) unless at the time of engaging such contractors You obtain and retain a copy of the relevant insurance policy schedule or other proof thereof that such contractors have in force: 1 an approved Employers Liability insurance in accordance with any law relating to compulsory insurance of liability to Persons Employed and 2 Public and Products Liability insurance suitable for the nature of the work undertaken on Your behalf and with a Limit of Indemnity not less than that applying to this Policy and containing an indemnity to principals clause. Participant to Participant Exclusion We shall not indemnify You under Sections 1 & 2 of this Insurance against liability arising from Injury caused by the acts or omissions of any participant towards another participant. Bodily Treatment Exclusion We shall not indemnify You under Sections 2 & 3 of this Insurance against liability arising from the provision of any medical or other bodily treatment (other than first aid and ambulance services). 2
Schedule to the Policy Professional Indemnity Exclusion We will not indemnify You in respect of liability arising out of or in connection with the failure of You to fulfil Your professional duties. Tour Operators Liability Exclusion We shall not indemnify You under Section 2 of this Insurance against liability arising from any package travel arrangement Height Limit Exclusion (15 Metres) We shall not indemnify You under Sections 1 & 2 of this Insurance against liability arising from any work carried out at heights exceeding 15 metres from ground level Hazardous Activities Exclusion We shall not indemnify You in respect of liability arising from or in connection with aqualung or scuba diving, bungee jumping or racing, go karting, hang gliding, microlite flying, motor racing, mountaineering (involving ropes or tackle), parachuting, potholing, quad or tri-biking, off road buggies, segways, water skiing or any other mechanically propelled vehicle. Territorial Limits Extension (Europe) Notwithstanding the Geographical Limits under Sections 1 & 2 of this Insurance We will indemnify You in respect of work carried out within other European Union countries and in connection with Your Business Medical And Repatriation Costs Exclusion We shall not indemnify You under section 1 of this Insurance for any costs incurred by You for medical and repatriation costs outside, Great Britain, Northern Ireland, the Isle of Man, the Channel Islands and any other EU Member State. Personal Accident and Travel Insurance Condition It is a condition precedent to Our liability that all overseas travellers hold valid Personal Accident and Travel Insurance. 3
Certificate of Employers Liability Insurance (a) In accordance with Regulation 5 of the Employers Liability (Compulsory Insurance) (Amendment) Regulations 2008 (the Regulations), one or more copies of this Certificate must be displayed at each place of business at which the Policyholder employs persons covered by this Policy. This requirement will be satisfied if the certificate is made available in electronic form and each relevant employee to whom it relates has reasonable access to it in that form. Policy Number: SALSALIA/M74221/0330/15 1 Name of Policyholder: Ultimate Training Days Ltd & Ultimate TDX Ltd 2 Date of Commencement of Insurance: 8 February 2015 3 Date of Expiry of Insurance: 7 February 2016 We hereby certify that subject to paragraph 2: 1 The Insurance to which this Certificate relates satisfies the requirements of the relevant law applicable to Great Britain, Northern Ireland, the Isle of Man, the Island of Guernsey, the Island of Jersey, the Island of Alderney (b) ; and 2 (a) The minimum amount of cover provided by this Policy is no less than GBP 5,000,000 (c) Signed: On behalf of certain Underwriters at Lloyd s, London Notes: (a) (b) (c) Where the employer is a company to which regulation 3(2) of the Regulations applies, the certificate shall state in a prominent place, either that the policy covers the holding company and all its subsidiaries, or that the policy covers the holding company and all its subsidiaries except any specifically excluded by name, or that the policy covers the holding company and only the named subsidiaries. Specify applicable law as provided for in regulation 4(6) of the Regulations. See regulation 3(1) of the Regulations and delete whichever of paragraphs 2(a) or 2(b) does not apply. Where 2(b) is applicable, specify the amount of cover provided by the relevant policy. Paragraph 2(b) does not apply and is deleted.
Statement of Facts Important Notice This Statement of facts is a record of the information and Material Facts advised to the Underwriters. The Proposed Insured by accepting this Statement of Facts confirms the truth of the information contained and that this is accurate and has not been misrepresented or mis-stated. The information contained in this statement of facts forms the basis for the acceptance of the proposal for insurance and the calculation of the premium and will form the basis of the contract of insurance between the Proposed Insured and Underwriters. Failure to disclose any Material Facts, which would be likely to influence the acceptance and assessment of the proposal, may result in the Underwriters refusing to provide indemnity or avoiding the policy in every respect. A Material Fact is one which an Underwriter would regard as likely to influence their assessment and acceptance of this insurance. Should the Proposed Insured have any doubt as to what may constitute a Material Fact they should contact you as their insurance broker. The insurance broker acting for the Proposed Insured should check this Statement on behalf of the Proposed Insured and if any of the information is incorrect you should amend the document and resubmit. Policy Number: Name of Proposed Insured: Correspondence Address Of Proposed Insured: SALSALIA/M74221/0330/15 Ultimate Training Days Ltd & Ultimate TDX Ltd 103 Cranbourne Road, Ashton-under-Lyme, Greater Manchester, OL7 9BW Trade or Business: Ultimate Training Days Ltd 1. Abseiling and multi-activity days/weekends. They use only established companies who have their own liability insurance. Employees will go along to assist and take part. 2. Over sea events (Europe only). Walking type activities only. Employees will go along to assist and take part. 3. Self Drive Charity road trips. Employees will go along as guides only. No taking part in the activities. Ultimate TDX Ltd Guided Walks - Groups of up to 50 walkers on guided tours in countryside, rural, mountainous areas (No use of ropes and or tackle). Predominately done all over the UK. The Proposed Insured is a: Cover and limits of indemnity: i) Employers Liability: ii) Public Liability: iii) Products Liability: Limited Company GBP 10,000,000 GBP 5,000,000 GBP 5,000,000 Annual Wage rolls as declared: a) Clerical: GBP b) All Other Employees: GBP 48,000 Annual Turnover as declared: Ultimate Training Days Ltd GBP 200,000 Ultimate TDX Ltd GBP 100,000 1
Payments to Bona-Fide Sub Contractors: GBP 40,000 No Proprietor, partner or Director of the Proposed Insured has ever: The work of the trade or business does not involve: The trade or business for which insurance is being sought is done within: Is there any use of heat equipment in connection with the trade or business?: Are any subsidiary companies included within this insurance quotation?: 1 had a proposal declined by an insurer 2 had an insurance renewal refused by an insurer 3 had an insurance cancelled by an insurer 4 had special terms imposed on an insurance 5 had any convictions for any criminal offence involving dishonesty arson theft or wilful damage or any prosecutions pending 6 been declared bankrupt or insolvent or been the subject of bankruptcy proceedings 7 for any of the classes of insurance under this Statement of Facts /policy for which cover is sought suffered any loss or had any claim made against them whether insured or not in the last five years (including current knowledge of any impending circumstances which could give rise to a claim) 1 work at heights exceeding 15.00 metres or depths exceeding 0.50 metres 2 the use of chemicals or other substances which could be harmful to health 3 the use of fixed woodworking machinery by employees Great Britain, Northern Ireland, Isle of Man and the Channel Islands No, No It is assumed unless advised by the proposer to the contrary that there is no work carried out at or on or in connection with: demolition except demolition solely undertaken with hand held tools and of structures not exceeding 5 metres in height when such work forms an ancillary part of a contract for construction alteration or repair construction alteration maintenance or repair of bridges viaducts towers steeples spires pylons or chimney shafts underpinning pile driving tunnelling quarries collieries mines ships blast furnaces power stations offshore gas or oil installations chemical works or gas refineries or storage facilities or any installation where nuclear processing is undertaken use of explosives airside or on or in the immediate vicinity of aircraft docks harbours railways or watercraft 2