Quote - Groups, Bands, Choirs & Orchestras

General Questions

Have you ever been declared bankrupt?: No Yes

Do you any County Court Judgements against you or Pending?: No Yes

Have you ever been refused insurance?: No Yes

Have you any previous or pending Criminal convictions (Not motoring offences)?: No Yes

Have you previously made an insurance claim In respect of the insurances requested above?: No Yes

If you have answered “Yes” to any of these questions please provide us with full details:
 

Applicant Details

1st Applicant

Title: Mr Mrs Miss Ms. Dr Prof Rev Other
Forenames:
Surname:
Company:

Date Of Birth: (DD/MM/YYYY)

Status: Single Married Other

Address

Address

House No/Name:
Address 1:
Address 2:
Town/City:
County:
Postcode:

Contact Details

Your Contact Details

Daytime Phone:
Home Phone:
Mobile (Optional):
E-mail (Required):
Facsimile (Optional):

Details and List of Activities to be Insured:

Notes

Name of Act/Band:
Type of Act/Band: Small Bands / Non Circus Activities Larger Bands / Circus Activities
No. of Members/Employees: Numerics only

Cover Required:

Public/Products Liability:

Limit of indemnity: £2,000,000 £5,000,000
Indemnity to iclude the use of heat/fire No Yes

Employers Liability:

Limit of indemnity: Not required £10,000,000
Indemnity to iclude the use of heat/fire No Yes
Employers PAYE Ref:

All Risks (Insert sums insured if required)

Total Sum Insured

Max Sum Insured (£): Numerics only

Cover Required:

Type of cover: Equipment on policy premises only To include 25% of equipment off premises To include 50% of equipment off premises To include 100% of equipment off premises

Cover equipment in a motor vehicle: No Yes
Worldwide cover: No Yes

How did you find Us?

How did you find Us?: Please Select One Art Profile Google Search Internet Forum Internet Link Mailout E-mail Magazine Advert Word of Mouth Workshop for Schools

Submit your Fact Find

Please note that you are not requesting cover by submitting this Fact Find merely request a premium indication, Our response will follow in due course (Office hours Monday to Friday 9am to 5pm)

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