Cover available to:
Permanent Residents of UK (except Eire) and Overseas Visitors temporarily working in the UK (except Eire)

General Questions


Applicant Details

Applicant
(DD/MM/YYYY)
Address
Contact Details

Activity Questions

Will I Require Employers Liability ?

You will require Employers Liability if a person works for you or your business (for example if you supply their work materials, control where or how they work, or generally treat them like an employee).

An employee can be paid or work on a voluntary basis.

Company directors of a Limited Company are also defined as employees of the company. If you're the sole director of your limited company, own 50% or more of the shares, and have no employees, Employers' Liability Insurance isn't required.

If in doubt as to the status of your workforce, please contact the office.

      Yes   No 

Performing at Height

Do any of your employees (as defined above) undertake any performance in excess of 3 meters above ground, floor or stage level?

Yes   No 

In respect of Performing at Height please describe the nature and frequency of your business activities and the roles and activities undertaken by any employees. Also please state at what height your employees will be performing.

Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?

Yes   No 

Do you and each person employed by you, have a minimum of 3 years' experience in the activities undertaken?

Yes   No 

Work at Height

Do you or any of your employees (as defined above) undertake rigging or staging work in excess of 3 meters above ground, floor or stage level?

Yes   No 

Are full risk assessments (including the use of Personal Protective Equipment and appropriate training) completed prior to the work commencing and are these kept by you?

Yes   No 

Do you comply with the current legislation for work at height EG. The work at height regulations act 2005 or any subsequent legislation?

Yes   No 

Do you and your employees have 3 or more years experience working at height?

Yes   No 

Do you or your employees undertake any work using rope access systems?

Yes   No 

Are you and all of your employees who use rope access systems qualified up to IRATA level 1 as a minimum?

Yes   No 

Do you or your employees undertake any work using powered access systems?

Yes   No 

Are you and all of your employees who use powered access systems IPAF qualified?

Yes   No 

Do you or your employees undertake work using mobile access systems?

Yes   No 

Are you and all of your employees who use mobile access systems PASMA qualified?

Yes   No 

Are all of your emplyees provided with personal fall protection systems including, but not limited to, fall arrest systems, work positioning systems, or restraint systems?

Yes   No 

Have you had any incidents, resulting in a claim or not as a result of working at height?

Yes   No 

Fire

In the course of your business activities, do any of your employees (as defined above) use any form of fire, pyrotechnics or any other process involving the application of heat?

Yes   No 

Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?

Yes   No 

Do all employees have a minimum of two years professional fire performing experience or have they completed a minimum of six paid fire performances over the preceding 12 months?

Yes   No 

Does any person employed by you undertake performance work involving the use of pyrotechnics (other than T1)?

Yes   No 

In respect of any employee activity including the use Heat, Fire or Pyrotechnics please describe the nature and frequency of your business activities and the roles and activities undertaken by any employees.

Stunts and Hazardous Routines

Do any of your employees (as defined above) perform any stunts or other routines that may be deemed hazardous (e.g. juggling with edged weapons, sword fighting, use of firearms or propulsion, special effects or the like)?

Yes   No 

In respect of any Stunts and Hazardous Routines please describe the nature and frequency of your business activities and the roles and activities undertaken by any employees.

Animals

In the course of your business activities, do you or any employees (as defined above) undertake performance or work involving the use of any animal?

Yes   No 

Do you and your employees have a minimum of 3 years' experience in the activities undertaken?

Yes   No 

Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?

Yes   No 

Do you or your employees activities include working with horses?

Yes   No 

Do you or your employees work with any animals classified under the Wild Animals Act 1976?

Yes   No 

Do you or your employees work with any animal classified under the Dangerous Dogs Act 1991?

Yes   No 

Black Powder & Projectile Weapons

Do you or your employees (as defined above) work with black powder, pistols, canons, guns or does your work include archery?

Yes   No 

Do you and your employees have a minimum of 3 years' experience in the activities undertaken?

Yes   No 

Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?

Yes   No 

Circus Skills

In the course of your businesss activities, do any employees (as defined above) undertake the performance of or tuition of any activity involving balancing in an unusual or hazardous manner (e.g. High-wire, Tightrope or the like)?

Yes   No 

Do you and your employees have a minimum of 3 years' experience in the activities undertaken?

Yes   No 

Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?

Yes   No 

Temporary Seating or Staging

In connection with any performances staged by you, do you ever erect temporary staging or seating/grandstands?

Yes   No 

Is this work carried out by qualified professionals with their own insurance?

Yes   No 

Details and List of Activities to be Insured:

 Numerics only

Cover Required:

Public/Products Liability:
Employers Liability:
All Risks (Insert sums insured if required)
Total Sum Insured:
 Numerics only
Cover Required:
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