Quotation Request

Social Club

Disclosure
Proposer Details
Premises
Cover Details
Directors & Officers
Outbuildings
Risk Information
Risk Protections
Claims

Disclosure Statement:

When taking out insurance wholly or mainly for purposes related to your trade, business or profession, you have a duty under The Insurance Act 2015 to make a fair presentation of the risk. This means that you must disclose every material circumstance which you and/or your senior management and/or anyone responsible for arranging your insurance know or ought to know. Alternatively, you must disclose sufficient information which would put the insurer on notice that it needs to make further enquiries for the purpose of revealing those material circumstances. You are expected to carry out a reasonable search in order to make a fair presentation of the risk and will be deemed to know what should reasonably have been revealed by the search.

Your duty of fair presentation applies at the start of the policy, at renewal and when any variation of the policy is arranged. If you fail to make a fair presentation, the insurer may refuse to pay your claim or reduce the settlement amount, depending on the circumstances.

I have read this statement:

Neither the Proposer, nor any directors or partners in the business have ever:-
had an insurance contract cancelled by an insurer.
Please provide full details:
had an insurance contract declared void by an insurer.
Please provide full details:
had different terms applied to an insurance contract by an insurer due to misrepresentation by:

  • providing misleading or incorrect information
  • deliberately or recklessly withholding information
  • providing false documents
  • Please provide full details:
    had insurance cover restricted or cancelled due to non-compliance with risk improvement requirements.
    Please provide full details:
    been convicted of or charged with but not yet tried for a criminal offence other than motoring offences.
    NOTE: Spent convictions (as defined under the Rehabilitation of Offenders Act 1974 or any similar or subsequent legislation) do not need to be declared.
    Please provide full details:
    Health & Safety
    Neither the Proposer, nor any directors or partners in the business either personally or in connection with the business or in any other business capacity has ever been:-
    convicted of (or charged but not yet tried with) a breach of any UK health and safety legislation by any official body regulatory authority or enforcing authority.
    Please provide full details:
    served with a prohibition notice or improvement notice in connection with any UK health and safety legislation by any official body regulatory authority or enforcing authority.
    Please provide full details:
    served with a clean-up notice in connection with any UK health and safety legislation by any official body regulatory authority or enforcing authority.
    Please provide full details:
    All lifting plant and pressure vessels/boilers which are subject to Statutory Regulations are regularly inspected by qualified engineers as required by the legislation.
    To the best of their knowledge the proposer complies with their legal obligations under UK health and safety legislation.
    Financial
    Neither the Proposer, nor any directors or partners in the business or in the name of any other business which any of us had an interest have:-
    been declared bankrupt or insolvent either as private individuals or in connection with any business within the last ten years.
    Please provide full details:
    been disqualified from holding a directorship.
    Please provide full details:
    been the subject of a County Court Judgement (or the Scottish equivalents) in respect of debt as private individuals or in connection with any business within the last six years.
    Please provide full details:
    been a director or partner in a business that has been the subject of a County Court Judgement (or the Scottish equivalents) in respect of debt within the last six years.
    Please provide full details:
    been officers of a company that has been declared insolvent, or had a receiver or liquidator appointed, or entered into arrangements with creditors in accordance with the Insolvency Act 1986 within the last ten years.
    Please provide full details:

    Proposer Details

    Inception Date
    Please provide full details of all sports carried out:
    Proposers name and trading name in full
    i.e. Mr & Mrs John Smith t/as The White Horse
    Contact Name
    Date of Birth
    Contact Number
    Mobile Number
    Email Address
    Company Number
    Reason for being ERN Exempt:
    Is there a Third Party Interest to be Noted?
    Third Party Interest
    Risk Address
    Please give full details of any previous Ownership / Managerial experience with the same trade:

    Premises

    The Premises / Buildings of the Business being proposed:
    have walls built of brick, stone or concrete?
    Please provide full details:
    have a roof of slate, tile, metal or concrete excluding any flat roof area?
    Please provide full details:
    Please advise construction:
    Has any flat felted roof on the premises been professionally inspected and any defects repaired within the last 2 years?
    are in a good state of repair and kept in a like manner?
    have a listed status?
    What Grade?
    Please advise what year the premises was built:
    located in a shopping centre, arcade or mill complex?
    Please provide full details:
    i.e. what type of building, what floor, etc.
    trade all year round?
    Please provide full details:
    i.e. when is the business closed, does the owner/employee live on whilst the premises are closed, etc.
    entirely self contained?
    i.e. with a separate lockable entrance and exit
    Please provide full details:
    are occupied solely by the business?
    What is the nature of the other business/businesses?
    have residential accommodation at the premises other than that which acts as the private dwelling of the proposer or their employees?
    Is residential accommodation let to Students, Asylum Seekers, Refugees or persons who receive Housing Benefits directly or indirectly?
    Please provide full details:
    i.e. who resides, is the lease directly with the tenant, etc.
    occupied by the proposer, or their employees, overnight?
    are free from storm exposure and/or are in an area which is free from flooding and at least 400 metres away from the nearest river, canal, lake or tidal waterway?
    Please provide full details:
    are free from, and in an area (within 400m of the premises) which is free from any signs of subsidence, heave and/or landslip?
    Please provide full details:
    i.e. when did the subsidence/landslip/heave occur, what has been done to the premises since, etc.
    had the Electrical Installation tested by a certified NICEIC, ELECSA or ECA Contractor within the last 5 years and all reported defects remedied?
    has an open fire, woodburning or multifuel stove?
    have any outbuildings?

    Cover Details

    Buildings
    Day One Reinstatement Value

    Including Subsidence and Landlords Fixtures and Fittings

    Including the value of all outbuildings

    £
    Signs
    Premium Charged
    £
    Please provide full details:
    Standard Buildings
    £
    Non Standard Buildings
    £
    Glass, Signs and Canopies
    £
    Loss of Rent Payable
    If Loss of Rent Receivable is required, please include in the Business Interruption figure
    £
    Tenants Improvements
    Including external signs, canopies, awnings, etc. for which the Insured is held legally responsible for
    £
    Playing Surfaces, Greens & Floodlights
    Maximum Sum Insured in respect of Floodlights is £15,000
    £
    Trade Fixtures & Fittings, Machinery, Plant and all Other Contents (Ex. Stock in Trade)

    Including Property Held in Trust

    Including the value of all outbuildings

    £
    Electronic Equipment & Computers (including EPOS systems and computerised tills)
    £
    Property in the Open
    Premium Charged
    £
    Please provide full details:
    Please provide full details of the Electronic Equipment:
    Maintenance Equipment in the Open
    £
    External Sports Equipment
    £
    Children's Outdoor Play Equipment
    £
    Cups & Trophies
    £
    Domestic Contents

    Single article limit of £1,500 (Excludes Jewellery and Antiques)

    The insured must reside on the premises

    Maximum £40,000 - If more are required, please see our separate 'Contents Plus' policy

    £
    Stock
    Including Materials in Trade, the Property of the Insured or in commission for which the Insured is held legally responsible
    £
    Wines & Spirits
    £
    Is Loss of Licence cover required?
    £100,000 Limit
    Tobacco
    £
    Deterioration of Stock
    £
    Goods In Transit
    £
    Money During Business Hours and In Transit
    £
    Money in Locked Safe outside Business Hours
    £
    Money in Gaming Machines
    Overall amount in all machines
    £
    Number of Gaming Machines
    Business Interruption
    £
    Estimated Annual Turnover
    £
    Total Number of Employees
    Estimated Annual Wageroll
    £
    Clerical Employees
    Clerical Annual Wageroll
    £
    Total Number of Committee Members
    Has a Health & Safety Risk Assessment of the premises been carried out by the proposer?
    A formal procedure is to be established that periodically audits the effectiveness of the companies health and safety documentation and procedures against best practice and to ensure that it reflects the hazards and risks to which the organisation and its employees and visitors are exposed. Once reviewed the documents should be signed and dated by a director and brought to the attention of all employees on a signed receipt basis.
    Is there a Health & Safety Policy in place?
    Employers' Liability is automatically included at £10,000,000
     

    Directors & Officers

    Is Directors & Officers cover required?
    Has any claim ever been made or prosecution brought against you in respect of the Insured as stated below, in respect of any neglect, error, omission or other wrongful act committed in the capacity of director or officer whether in relation to the activities of the insured or any other company in which the directors or officers hold or have held office?
    Please ensure full information is included in the claims section at the end of the quotation
    Is the Insured aware, after enquiry, of any circumstances or incident which might give rise to a claim against the Insured or any director of officer of the Insured?
    Please provide full details:
    Is the Insured aware, after enquiry, of any circumstances or incident which might otherwise affect the Insurers consideration of this insurance?
    Please provide full details:
    Have all claims or circumstances which might give rise to a claim been reported to Insurers?
    Please provide full details:
    Has the Insured been established for more than 3 years?
    Please provide full details:
    Do you have your accounts checked by an accountant annually?
    Please provide full details:
    Do your total gross assets exceed your total liabilities (debts)?
    Please provide full details:
    Have you ever been refused Directors & Officers Liability Insurance or quoted increased premiums or special terms?
    Please provide full details:

    Outbuildings

    Are all walls built of brick, stone or concrete?
    Please provide full details:
    What is the total value of the Contents kept in the outbuilding?
    £
    What is the total value of any Plant & Machinery kept in the outbuilding?
    £
    What is the Maximum Item Value?
    £
    Does the proposed outbuilding comply with the minimum security requirements described below?
    1) The Final Exit Door of the premises is fitted with either a mortice deadlock / hook lock, which has 5 or more levers with matching boxed striking plate and conforms to BS3621 standard, or a cylinder operated deadlock or a deadlocking multi-point locking system. Timber doors frames to be at least 45mm thick. All aluminium framed doors are to be fitted with a swing bolt type mortice deadlock.
    2) All other external doors and all internal doors giving access to any part of the building not occupied by the insured for the purposes of the business, are fitted with either, the security detailed in 1), or two key operated security bolts of doors, fitted approximately 30cm from both the top and bottom of the door.
    3) All Cellar Flaps are fitted with the security as detailed in 1), or 5 lever close-shackle padlocks, together with substantial locking bars.
    4) All ground floor and basement opening windows and skylights and all other opening windows and skylights, accessible from roofs, balconies, decks, canopies, down pipes or canopies must be fitted with key operated window locks or permanently fixed shut.
    Any door or window officially designated to be a Fire Exit by the Fire Authority is excluded from these requirements.
    Please provide full details:
    i.e type of locks, how they don't comply, etc.
    Second Outbuilding
    Are all walls built of brick, stone or concrete?
    Please provide full details:
    What is the total value of the Contents kept in the outbuilding?
    £
    What is the total value of any Plant & Machinery kept in the outbuilding?
    £
    What is the Maximum Item Value?
    £
    Does the proposed outbuilding comply with the minimum security requirements described below?
    1) The Final Exit Door of the premises is fitted with either a mortice deadlock / hook lock, which has 5 or more levers with matching boxed striking plate and conforms to BS3621 standard, or a cylinder operated deadlock or a deadlocking multi-point locking system. Timber doors frames to be at least 45mm thick. All aluminium framed doors are to be fitted with a swing bolt type mortice deadlock.
    2) All other external doors and all internal doors giving access to any part of the building not occupied by the insured for the purposes of the business, are fitted with either, the security detailed in 1), or two key operated security bolts of doors, fitted approximately 30cm from both the top and bottom of the door.
    3) All Cellar Flaps are fitted with the security as detailed in 1), or 5 lever close-shackle padlocks, together with substantial locking bars.
    4) All ground floor and basement opening windows and skylights and all other opening windows and skylights, accessible from roofs, balconies, decks, canopies, down pipes or canopies must be fitted with key operated window locks or permanently fixed shut.
    Any door or window officially designated to be a Fire Exit by the Fire Authority is excluded from these requirements.
    Please provide full details:
    i.e type of locks, how they don't comply, etc.
    Third Outbuilding
    Are all walls built of brick, stone or concrete?
    Please provide full details:
    What is the total value of the Contents kept in the outbuilding?
    £
    What is the total value of any Plant & Machinery kept in the outbuilding?
    £
    What is the Maximum Item Value?
    £
    Does the proposed outbuilding comply with the minimum security requirements described below?
    1) The Final Exit Door of the premises is fitted with either a mortice deadlock / hook lock, which has 5 or more levers with matching boxed striking plate and conforms to BS3621 standard, or a cylinder operated deadlock or a deadlocking multi-point locking system. Timber doors frames to be at least 45mm thick. All aluminium framed doors are to be fitted with a swing bolt type mortice deadlock.
    2) All other external doors and all internal doors giving access to any part of the building not occupied by the insured for the purposes of the business, are fitted with either, the security detailed in 1), or two key operated security bolts of doors, fitted approximately 30cm from both the top and bottom of the door.
    3) All Cellar Flaps are fitted with the security as detailed in 1), or 5 lever close-shackle padlocks, together with substantial locking bars.
    4) All ground floor and basement opening windows and skylights and all other opening windows and skylights, accessible from roofs, balconies, decks, canopies, down pipes or canopies must be fitted with key operated window locks or permanently fixed shut.
    Any door or window officially designated to be a Fire Exit by the Fire Authority is excluded from these requirements.
    Please provide full details:
    i.e type of locks, how they don't comply, etc.
    Please provide the full details for all remaining outbuildings:

    Risk Information

    Is frying undertaken at the premises, other than shallow frying?
    Is there a full frying range (fish & chip shop style) located and used at the premises?
    Are the kitchen and/or canopy hood, range extraction systems and ducting annually maintained and cleaned by professional contractor?
    Is the Range maintained and cleaned at least once a year by an independent contractor?
    Is a Pressure Cooker used at the premises?
    Number of Covers:
    Seating capacity at any one time
    Are any of the following in place at the premises:
    Are there any guestrooms available to let?
    How many rooms are available to let?
    Event Hire for private functions including Weddings, Birthdays, Christenings, Wakes etc. held more than twice a month?
    Please provide full details:
    i.e. what types of events is hire available for, how often are these events, etc.
    Outside Catering?
    Please provide full details:
    i.e. what services are offered, is any cooking carried out at third party premises, how many employees are involved, how many events are undertaken per year, etc.
    Live Music / Entertainment?
    Is Live Music, including solo artists, bands, karaoke, DJ's etc, provided more than twice in any seven day period?
    Please provide full details:
    i.e. what kind of entertainment is offered, how often, etc.
    Dance Floor?
    Is there a written Spillage Policy in place?
    Entrance Fee(s) other than at Christmas and New Year, or a small charge to members on nights with Live Music to cover the cost of the act?
    Please provide full details:
    i.e. when, for what events, how much, how many people, etc.
    Door Staff?
    Are the door staff licensed and hired from an approved SIA Third Party Agency?
    Please provide full details:
    i.e. how often are door staff are used, how many etc.
    Late License? (After 1am)
    Please provide full details:
    i.e. what time do the premises close, how often do they open after 1am, etc.
    Please provide full details:
    what does this include?
    ATM?
    Is the management of the ATM the Proposer's responsibility?
    What is the maximum the ATM holds at any one time?
    This amount needs to be included within the money limits if cover is required
    £
    Is the ATM bolted down?
    Is the ATM emptied every night?
    Is there CCTV covering the ATM?

    Risk Protections

    Does the proposed premises comply with the minimum security requirements described below?
    1) The Final Exit Door of the premises is fitted with either a mortice deadlock / hook lock, which has 5 or more levers with matching boxed striking plate and conforms to BS3621 standard, or a cylinder operated deadlock or a deadlocking multi-point locking system. Timber doors frames to be at least 45mm thick. All aluminium framed doors are to be fitted with a swing bolt type mortice deadlock.
    2) All other external doors and all internal doors giving access to any part of the building not occupied by the insured for the purposes of the business, are fitted with either, the security detailed in 1), or two key operated security bolts of doors, fitted approximately 30cm from both the top and bottom of the door.
    3) All Cellar Flaps are fitted with the security as detailed in 1), or 5 lever close-shackle padlocks, together with substantial locking bars.
    4) All ground floor and basement opening windows and skylights and all other opening windows and skylights, accessible from roofs, balconies, decks, canopies, down pipes or canopies must be fitted with key operated window locks or permanently fixed shut.
    Any door or window officially designated to be a Fire Exit by the Fire Authority is excluded from these requirements.
    Please provide full details:
    i.e type of locks, how they don't comply, etc.
    Are the premises thoroughly protected by an intruder alarm system, under the sole control of the insured?
    What type of alarm is installed?
    Does the alarm have Police Response?
    Are the premises protected by an automatic fire detection and warning system that runs from the mains electricity (with battery back-up)?
    Have you carried out a Fire Risk Assessment?
    What fire safety measures are in place?
    Is the CCTV recordable?
    How many days are the CCTV recordings stored for?
    Are CCTV recordings kept offsite?
    How many miles away from the premises is the nearest Police Station?
    miles
    How many miles away from the premises is the nearest Fire Station?
    miles

    Claims

    Has the Proposer(s), Partner(s) or Directors(s) suffered a loss, claim or incident (which may give rise to a claim) at these premises, or any other premises, whether insured or not within the last 5 years?
    Please provide details:
    Date Type of ClaimDetails PaidReserveMeasures Taken
    Add row

    Additional Information

    Do you want to bring any further information to the underwriters attention?
    Please provide full details:
    Current Insurer
    Target Premium
    £
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