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EVENTS INSURANCE FORM
Namefull name
Addresssomething more
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Postal / Zip Codefull name
Telephone No.full name
Policy Currencyfull name
Event Namefull name
Type of Eventfull name
Venuefull name
Cityfull name
Countryfull name
Event Start Datemake a booking
Event End Datemake a booking
Event Locationto order
Has this Event been held before?to order
If no, please provide details of Proposer's experience in organising eventsfull name
100% Event Gross Revenuefull name
100% Event Costs & Expensesfull name
100% Event net profitfull name
Please confirm the basis on which you would like to insureyou like
Please confirm the basis on which you would like to insurefull name
Informationhow good was the food?
PoorAverageGood
Adverse weather cover - If any part of the Event takes place outdoors or under temporary structures, is adverse weather cover required? If "Yes", please complete Appendix A
Non appearance cover - Would the non appearance of a specific Key Individual or group of individuals cause cancellation of this Event?
Event Liability cover - Is liability insurance also required for this Event? If "Yes", please complete Appendix C
General Question
Ratingshow good was the food?
PoorAverageGood
Have all contractual arrangements necessary for the successful fulfilment of the event been made and confirmed i
Has any Event(s) in which the You were involved (in managing) had any incident that could have resulted, or did result, in financial loss that would be covered under the proposed insurance?
Are You aware of any matter, fact, circumstance or incident existing or threatened that could possibly affect the performance(s) or Event(s), and might result in a loss under this insurance?
Have You, or any other person to which this insurance would apply, ever been declined insurance, or had any such insurance cancelled, or renewal refused, or had special terms imposed?
CONDITIONS OF QUOTATION Any terms provided by Us as a result of non binding indication and any supporting information will be subject to: 1. Final acceptance by You and then Us prior to the quote expiry date shown in the non binding indication, after which the resulting insurance cannot be cancelled. 2. You undertaking to advise Us of any change in the supporting information or additional information that should be supplied to make this non binding indication current, occurring prior to the inception date of any insurance subsequently issued. 3. Final acceptance by You and then Us prior to the quote expiry date shown in the non binding indication, after which the resulting insurance cannot be cancelled. 4. You having declared all material facts likely to influence a reasonable Underwriter in determining:
  1. whether or not to accept the risk,
  2. the premium
  3. the terms, conditions, exclusions and limitations
5. You, if acting on behalf of others, being deemed to have obtained and declared all the information provided after making enquiry of each of them.
  1. any intermediary(ies) acting on behalf of any parties referred to in 4(a), being deemed to have obtained and declared all the information provided after making inquiry of the party(ies) for whom they act
  2. You accepting the quotation doing so on behalf of all others and accepting responsibility for payment of the premium as detailed in 7 below
6. You undertaking that no other insurance has been purchased on this specific risk and none shall be without Our prior written approval; in the event of such approval being given, the terms, conditions, exclusions, limitations and premium set out in any non binding 7. You paying the premium with acceptance of the non binding indication. If (in accordance with 1 and 3 above) We do not accept the risk, the premium will be returned.
Declaration
To the best of Your knowledge and belief and having diligently made all necessary inquiries the information provided in connection with this proposal, whether in Your own hand or not, is true and You have not withheld any material facts. You understand that non-disclosure or misrepresentation of a *material fact will entitle Us to void the Insurance. NOTE: * A material fact is one likely to influence acceptance or assessment of this Proposal by Us: if You are in any doubt as to what constitutes a material fact You should consult your Broker. It is understood that the signing of this Proposal does not bind You to complete or Us to accept this Insurance, but You agree that, should a contract of insurance be concluded, this Proposal and any supporting information shall be incorporated into and form the basis of the contract.
I/We declare that the information provided above and in all appending sections is true to the best of My/Our knowledge.
Datemake a booking
Namefull name
Position Heldfull name
Underwritten by syndicates 623 and 2623 at Lloyd's. Beazley Solutions Limited is a service company that is part of the Beazley group of companies. Beazley Solutions Limited has authority to enter into contracts of insurance on behalf of the Lloyd’s underwriting members of Lloyd’s syndicates 623 and 2623 which are managed by Beazley Furlonge Limited. Beazley Solutions Limited is an appointed representative of Beazley Furlonge Limited which is authorised and regulated by the UK Financial Services Authority (Firm Reference Number: 204896) in its capacity as insurer.
Proposal form general events event cancellation. If adverse weather cover is required, please complete the following questions. Please Note: If the Event is indoors, the policy automatically covers cancellation due to adverse weather conditions. Please only complete this section if part of the Event takes place outdoors or under temporary structures and if cover is required for adverse weather.
1. What proportion of the Event (in monetary terms) takes place outside or under temporary structures?full name
2. Can the Event proceed in continuous moderate rain fall and wind speeds of up to 40mph?full name
3. Does the Event venue have any history of flooding or exposure to strong winds?full name
4. Can the outdoor elements of the Event be relocated indoors, at no additional expense, in the event of bad weather?full name
5. If the outdoor elements of the Event have to be cancelled due to weather, will the indoor elements still proceed?full name
6. Has the Event been held at the same time of year and location in the past?full name
7. Is the Event location within 100 metres of a lake, river or watercourse?full name
8. Can the Event be delayed or postponed if bad weather renders it dangerous or impossible to proceed?full name
9. If you have any additional comments regarding the outdoor elements of the Event, and it's susceptiblity to bad weather, please add them here.something more
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A) If individual non appearance cover is required, please complete the following questions. Please Note: The policy will contain a 30 day health warranty and a full pre existing medical conditions exclusion
Name of Key Individual(s)full name
Date of birthmake a booking
How will the Key Individual(s) travel to the event?full name
Is the Key Individual(s) contracted to appear at this event?full name
How long before the Event are they due to arrive?full name
Does the Key Individual(s) have any prior commitments which may affect their ability to attend the event? If Yes, please give detailssomething more
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Is a replacement available if the Key Individual(s) is unable to attend the event? If Yes, please give detailsIf Yes, please give detailssomething more
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Does the Key Individual(suffer from any physical, mental or medical condition? If Yes, please give detailssomething more
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Is the Key Individual(s) undergoing any form of treatment, medical or otherwise? If Yes, please give detailssomething more
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Is the Key Individual(s) following any prescribed regime, medical or otherwise? If Yes, please give detailssomething more
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Does the Key Individual(s) have any history of non appearance? If Yes, please give detailssomething more
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Is the Key Individual(s) a member of the Royal Family or a serving/former Head of State? If Yes, please give detailssomething more
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B) If simultaneous non appearance cover is required, please complete the following questions. Please Note: Cover is an extension for simultaneous catasrophic non appearance of 25% or more of Participants due to a Common Accident or Common Illness
Please confirm there are 20 or more Participants in total. If No, please advise the number of participantsfull name
A) If public liability cover is required, please complete the following questions.
Tenancy from datemake a booking
Tenancy to datemake a booking
Number of attendeesfull name
Max per day:full name
Other (please specify)full name
Does the Event include any of the following activities?how good was the food?
PoorAverageGood
Bouncy Castles
Creches
Fariground Rides
If so, do You provide, operate or control any of these activities or equipment Yourselves?full name
If No, has evidence of current PL & EL been obtained from the sub-contractors that provide, operate or control any of these activities or equipment?full name
Do any other acitivites need to be considered? If Yes, please give detailssomething more
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Do You have any U.S. assets?full name
B) If employers liability cover is required, please complete the following questions. Please Note: Employers liability cover is only available if You are based in the UK
Who is classed as an Employee?
  • Temporary employees (paid or unpaid)
  • Person(s) hired to, or borrowed by You
  • Labour master or labour only sub contractor or person(s) supplied or employed by them
  • Self employed person(s)
  • Volunteers or unpaid person(s)
  • Person undertaking study or work experience or youth training scheme
Please provide details of the Employees at this Event
a) Managerial and clerical, employees who do not engage in manual labour
No. Of Employeesfull name
Payments in relation to this Eventfull name
b) Manual Employees
No. Of Employeesfull name
Payments in relation to this Eventfull name
Please describe duties of the volunteersfull name
c) Labour only sub-contractors & self employed sub contractors supplying Labour
No. Of Employeesfull name
Payments in relation to this Eventfull name
Please describe duties of the volunteersfull name
d) Volunteers
No. Of Employeesfull name
Payments in relation to this Eventfull name
Please describe duties of the volunteersfull name
If any claims for personal injury or damage to property by third parties or employees have been made against You in the past 5 years, please provide detailsfull name
Group
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