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Type of insurance
Please select which of the following insurance products you would like to add to your policy
Public Liability
including optional Employers Liability Insurance
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Technical & Portable Equipment Insurance
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Business Contents
including optional Buildings and Business Interruption Insurance
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*All fields on this page are mandatory
**At least one of the fields on this page are mandatory
General questions
What is your title? *
(Select)
Mr
Mrs
Miss
Ms
Dr
Prof
Rev
What is your first name? *
What is your last name? *
What is your email address? *
i
Confirm email address *
The email you've entered is already registered with us. Please provide the password for this account or change the email address.
What is your password? *
i
[Forgotten my password]
What is your website address?
What is your telephone number
(inc. country dialing code)
**
What is your mobile number
(inc. country dialing code)
**
Where is your business domiciled/registered? *
(Select)
Channel Isles
England
Isle of Man
Northen Ireland
Other
Scotland
Wales
Name the other country where you are domiciled? *
What is the legal status of your business? *
(Select)
Club/Association
Limited Company (incl. CICs)
Limited Liability Partnership
Other
Partnership
Registered Charity
Sole Proprietor
Tell us the legal status of your business *
Type the name of your business partner(s) including yourself if you are a partner, one at a time and click the add button
Name of business partner? *
modification link
Are you, or any partner or director of your business, a member of any of any trade unions or trade associations? *
Yes
No
Please select your membership(s) from the list *
AMPdj
BECTU
Equity
European Piano Teachers Association
European String Teachers Association
Incorporated Society of Musicians
Mobile DJ Network
Musicians Union
National Association of DJs
NVPN
Other - not listed
SEDA
Sound Sense
i
Please enter your list of other not listed membership(s) *
Please select the description from the list that best describes your business activity: *
(Select)
Circus groups, productions, workshops and schools
Concert Production Company
Dance productions, workshops and schools
Dance Troupe (less than 100 members)
Dance Troupe (more than 100 members)
Disc Jockey
Film & TV Production Company
Historical Re-enactment Society
Musicians, Bands or Orchestras (less than 25 members)
Musicians, Bands or Orchestras (more than 25 members)
Orchestral Production Company
Other
Recording Studio / Rehearsal Rooms
Theatre groups, productions, workshops and schools
Variety Acts / Performers
i
Please provide a description of your business activities: *
What date was your company established? * (mm/yyyy)
/
i
Is your business currently insured with Hiscox for any of the insurances provided by this policy? *
Yes
No
From what date do you want your cover to commence? *
i
When do you want your cover to end? *
i
Have you made any claims in the last 5 years? *
Yes
No
Claim details
Claim
Include claim?
Yes
No
What was the date of the claim?
What was the amount claimed?
What was the nature of the claim?
(Select)
Accidental Damage
Burst Pipe
Employers Liability
Fire
Flood
Malicious Damage
Products Liability
Public Liability – Personal Injury
Public Liability – Property Damage
Riot
Storm
Theft – away from the premises
Theft – from the premises
Water Ingress
Was this claim settled?
Yes
No
Claim
Include claim?
Yes
No
What was the date of the claim?
What was the amount claimed?
What was the nature of the claim?
(Select)
Accidental Damage
Burst Pipe
Employers Liability
Fire
Flood
Malicious Damage
Products Liability
Public Liability – Personal Injury
Public Liability – Property Damage
Riot
Storm
Theft – away from the premises
Theft – from the premises
Water Ingress
Was this claim settled?
Yes
No
Claim
Include claim?
Yes
No
What was the date of the claim?
What was the amount claimed?
What was the nature of the claim?
(Select)
Accidental Damage
Burst Pipe
Employers Liability
Fire
Flood
Malicious Damage
Products Liability
Public Liability – Personal Injury
Public Liability – Property Damage
Riot
Storm
Theft – away from the premises
Theft – from the premises
Water Ingress
Was this claim settled?
Yes
No
Claim
Include claim?
Yes
No
What was the date of the claim?
What was the amount claimed?
What was the nature of the claim?
(Select)
Accidental Damage
Burst Pipe
Employers Liability
Fire
Flood
Malicious Damage
Products Liability
Public Liability – Personal Injury
Public Liability – Property Damage
Riot
Storm
Theft – away from the premises
Theft – from the premises
Water Ingress
Was this claim settled?
Yes
No
Claim
Include claim?
Yes
No
What was the date of the claim?
What was the amount claimed?
What was the nature of the claim?
(Select)
Accidental Damage
Burst Pipe
Employers Liability
Fire
Flood
Malicious Damage
Products Liability
Public Liability – Personal Injury
Public Liability – Property Damage
Riot
Storm
Theft – away from the premises
Theft – from the premises
Water Ingress
Was this claim settled?
Yes
No
Details of your business premises
Please provide details of each of your business premises for which you require cover. Once the minimum details for a property have been successfully entered, you will be given the option to add another property to the policy (up to 5 properties maximum).
Premises
Include premises?
Yes
No
Postcode *
Find Address
Please select address from the list below
Address line 1 *
Address line 2
Address line 3
Town or city *
County *
What type of property is this? *
(Select)
Commercial
Residential
Business contents cover
Do you own the contents relating to your business? If so, would you like to protect them against loss, theft or accidental damage?
Yes
No
i
Business Contents cover
Yes
No
What is the replacement value of your Computer & Ancillary Equipment (excluding portable equipment used away from the premises)?
i
What is the replacement value of all other business contents (excluding any items of technical equipment used away from the premises)?
i
Rent payable
i
The standard limit for money cover is £1,000, do you want to increase this limit?
Yes
No
Please select the money cover limit
(Select)
£2,500
£5,000
i
Buildings cover
Do you own the building you work from or would you like to protect it against damage?
Yes
No
Do you require buildings cover? *
Yes
No
What is the rebuilding cost of your building? *
i
Do you wish to insure any rental income you receive from this building?
Yes
No
i
How much rental income do you wish to insure? *
i
How many months of rental income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
i
Technical and portable equipment cover
Technical and portable equipment cover
Yes
No
i
Owned Equipment
Technical and portable owned equipment cover
Yes
No
i
Do you require cover for owned portable computer equipment? *
Yes
No
i
What is the replacement value of your owned portable computer equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned technical, photographic & audio visual equipment? *
Yes
No
i
What is the replacement value of your owned technical, photographic & audio visual equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned musical instruments & accessories? *
Yes
No
What is the replacement value of your owned musical instruments & accessories? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned props, sets & wardrobes? *
Yes
No
i
What is the replacement value of your owned props, sets & wardrobes? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Hired-In Equipment
Technical and portable hired equipment cover
Yes
No
i
Do you require cover for hired technical, photographic & audio visual equipment? *
Yes
No
i
What is the maximum value of hired technical, photographic & audio visual equipment you will have at any one time? *
i
How much do you estimate paying in hiring charges for hired technical, photographic & audio visual equipment during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired musical instruments & accessories? *
Yes
No
i
What is the maximum value of hired musical instruments & accessories you will have at any one time? *
i
How much do you estimate paying in hiring charges for musical instruments & accessories during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired props, sets & wardrobes? *
Yes
No
i
What is the maximum value of hired props, sets & wardrobes you will have at any one time? *
i
How much do you estimate paying in hiring charges for props, sets & wardrobes during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you ever keep hired equipment on the insured business premises overnight? *
Yes
No
i
Please enter the total sum insured kept at the premises overnight *
i
General technical and portable equipment questions
Does the value of any one single item to be insured exceed £50,000?
Yes
No
i
Business interruption cover
If your insured contents or buildings were to be damaged, or you had restricted access to your building would this impact your ability to continue working?
Yes
No
Business interruption cover
Yes
No
i
What basis of cover do you require? *
Loss of income
Increased cost of working
i
Loss of income sum insured
How many months of loss of income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Increased cost of working sum insured
How many months of increased cost of working do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Do you require cover for outstanding debts? *
Yes
No
i
Outstanding debts sum insured
i
Premises
Include premises?
Yes
No
Postcode *
Find Address
Please select address from the list below
Address line 1 *
Address line 2
Address line 3
Town or city *
County *
What type of property is this? *
(Select)
Commercial
Residential
Business contents cover
Do you own the contents relating to your business? If so, would you like to protect them against loss, theft or accidental damage?
Yes
No
i
Business Contents cover
Yes
No
What is the replacement value of your Computer & Ancillary Equipment (excluding portable equipment used away from the premises)?
i
What is the replacement value of all other business contents (excluding any items of technical equipment used away from the premises)?
i
Rent payable
i
The standard limit for money cover is £1,000, do you want to increase this limit?
Yes
No
Please select the money cover limit
(Select)
£2,500
£5,000
i
Buildings cover
Do you own the building you work from or would you like to protect it against damage?
Yes
No
Do you require buildings cover? *
Yes
No
What is the rebuilding cost of your building? *
i
Do you wish to insure any rental income you receive from this building?
Yes
No
i
How much rental income do you wish to insure? *
i
How many months of rental income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
i
Technical and portable equipment cover
Technical and portable equipment cover
Yes
No
i
Owned Equipment
Technical and portable owned equipment cover
Yes
No
i
Do you require cover for owned portable computer equipment? *
Yes
No
i
What is the replacement value of your owned portable computer equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned technical, photographic & audio visual equipment? *
Yes
No
i
What is the replacement value of your owned technical, photographic & audio visual equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned musical instruments & accessories? *
Yes
No
What is the replacement value of your owned musical instruments & accessories? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned props, sets & wardrobes? *
Yes
No
i
What is the replacement value of your owned props, sets & wardrobes? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Hired-In Equipment
Technical and portable hired equipment cover
Yes
No
i
Do you require cover for hired technical, photographic & audio visual equipment? *
Yes
No
i
What is the maximum value of hired technical, photographic & audio visual equipment you will have at any one time? *
i
How much do you estimate paying in hiring charges for hired technical, photographic & audio visual equipment during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired musical instruments & accessories? *
Yes
No
i
What is the maximum value of hired musical instruments & accessories you will have at any one time? *
i
How much do you estimate paying in hiring charges for musical instruments & accessories during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired props, sets & wardrobes? *
Yes
No
i
What is the maximum value of hired props, sets & wardrobes you will have at any one time? *
i
How much do you estimate paying in hiring charges for props, sets & wardrobes during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you ever keep hired equipment on the insured business premises overnight? *
Yes
No
i
Please enter the total sum insured kept at the premises overnight *
i
General technical and portable equipment questions
Does the value of any one single item to be insured exceed £50,000?
Yes
No
i
Business interruption cover
If your insured contents or buildings were to be damaged, or you had restricted access to your building would this impact your ability to continue working?
Yes
No
Business interruption cover
Yes
No
i
What basis of cover do you require? *
Loss of income
Increased cost of working
i
Loss of income sum insured
How many months of loss of income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Increased cost of working sum insured
How many months of increased cost of working do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Do you require cover for outstanding debts? *
Yes
No
i
Outstanding debts sum insured
i
Premises
Include premises?
Yes
No
Postcode *
Find Address
Please select address from the list below
Address line 1 *
Address line 2
Address line 3
Town or city *
County *
What type of property is this? *
(Select)
Commercial
Residential
Business contents cover
Do you own the contents relating to your business? If so, would you like to protect them against loss, theft or accidental damage?
Yes
No
i
Business Contents cover
Yes
No
What is the replacement value of your Computer & Ancillary Equipment (excluding portable equipment used away from the premises)?
i
What is the replacement value of all other business contents (excluding any items of technical equipment used away from the premises)?
i
Rent payable
i
The standard limit for money cover is £1,000, do you want to increase this limit?
Yes
No
Please select the money cover limit
(Select)
£2,500
£5,000
i
Buildings cover
Do you own the building you work from or would you like to protect it against damage?
Yes
No
Do you require buildings cover? *
Yes
No
What is the rebuilding cost of your building? *
i
Do you wish to insure any rental income you receive from this building?
Yes
No
i
How much rental income do you wish to insure? *
i
How many months of rental income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
i
Technical and portable equipment cover
Technical and portable equipment cover
Yes
No
i
Owned Equipment
Technical and portable owned equipment cover
Yes
No
i
Do you require cover for owned portable computer equipment? *
Yes
No
i
What is the replacement value of your owned portable computer equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned technical, photographic & audio visual equipment? *
Yes
No
i
What is the replacement value of your owned technical, photographic & audio visual equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned musical instruments & accessories? *
Yes
No
What is the replacement value of your owned musical instruments & accessories? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned props, sets & wardrobes? *
Yes
No
i
What is the replacement value of your owned props, sets & wardrobes? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Hired-In Equipment
Technical and portable hired equipment cover
Yes
No
i
Do you require cover for hired technical, photographic & audio visual equipment? *
Yes
No
i
What is the maximum value of hired technical, photographic & audio visual equipment you will have at any one time? *
i
How much do you estimate paying in hiring charges for hired technical, photographic & audio visual equipment during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired musical instruments & accessories? *
Yes
No
i
What is the maximum value of hired musical instruments & accessories you will have at any one time? *
i
How much do you estimate paying in hiring charges for musical instruments & accessories during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired props, sets & wardrobes? *
Yes
No
i
What is the maximum value of hired props, sets & wardrobes you will have at any one time? *
i
How much do you estimate paying in hiring charges for props, sets & wardrobes during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you ever keep hired equipment on the insured business premises overnight? *
Yes
No
i
Please enter the total sum insured kept at the premises overnight *
i
General technical and portable equipment questions
Does the value of any one single item to be insured exceed £50,000?
Yes
No
i
Business interruption cover
If your insured contents or buildings were to be damaged, or you had restricted access to your building would this impact your ability to continue working?
Yes
No
Business interruption cover
Yes
No
i
What basis of cover do you require? *
Loss of income
Increased cost of working
i
Loss of income sum insured
How many months of loss of income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Increased cost of working sum insured
How many months of increased cost of working do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Do you require cover for outstanding debts? *
Yes
No
i
Outstanding debts sum insured
i
Premises
Include premises?
Yes
No
Postcode *
Find Address
Please select address from the list below
Address line 1 *
Address line 2
Address line 3
Town or city *
County *
What type of property is this? *
(Select)
Commercial
Residential
Business contents cover
Do you own the contents relating to your business? If so, would you like to protect them against loss, theft or accidental damage?
Yes
No
i
Business Contents cover
Yes
No
What is the replacement value of your Computer & Ancillary Equipment (excluding portable equipment used away from the premises)?
i
What is the replacement value of all other business contents (excluding any items of technical equipment used away from the premises)?
i
Rent payable
i
The standard limit for money cover is £1,000, do you want to increase this limit?
Yes
No
Please select the money cover limit
(Select)
£2,500
£5,000
i
Buildings cover
Do you own the building you work from or would you like to protect it against damage?
Yes
No
Do you require buildings cover? *
Yes
No
What is the rebuilding cost of your building? *
i
Do you wish to insure any rental income you receive from this building?
Yes
No
i
How much rental income do you wish to insure? *
i
How many months of rental income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
i
Technical and portable equipment cover
Technical and portable equipment cover
Yes
No
i
Owned Equipment
Technical and portable owned equipment cover
Yes
No
i
Do you require cover for owned portable computer equipment? *
Yes
No
i
What is the replacement value of your owned portable computer equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned technical, photographic & audio visual equipment? *
Yes
No
i
What is the replacement value of your owned technical, photographic & audio visual equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned musical instruments & accessories? *
Yes
No
What is the replacement value of your owned musical instruments & accessories? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned props, sets & wardrobes? *
Yes
No
i
What is the replacement value of your owned props, sets & wardrobes? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Hired-In Equipment
Technical and portable hired equipment cover
Yes
No
i
Do you require cover for hired technical, photographic & audio visual equipment? *
Yes
No
i
What is the maximum value of hired technical, photographic & audio visual equipment you will have at any one time? *
i
How much do you estimate paying in hiring charges for hired technical, photographic & audio visual equipment during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired musical instruments & accessories? *
Yes
No
i
What is the maximum value of hired musical instruments & accessories you will have at any one time? *
i
How much do you estimate paying in hiring charges for musical instruments & accessories during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired props, sets & wardrobes? *
Yes
No
i
What is the maximum value of hired props, sets & wardrobes you will have at any one time? *
i
How much do you estimate paying in hiring charges for props, sets & wardrobes during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you ever keep hired equipment on the insured business premises overnight? *
Yes
No
i
Please enter the total sum insured kept at the premises overnight *
i
General technical and portable equipment questions
Does the value of any one single item to be insured exceed £50,000?
Yes
No
i
Business interruption cover
If your insured contents or buildings were to be damaged, or you had restricted access to your building would this impact your ability to continue working?
Yes
No
Business interruption cover
Yes
No
i
What basis of cover do you require? *
Loss of income
Increased cost of working
i
Loss of income sum insured
How many months of loss of income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Increased cost of working sum insured
How many months of increased cost of working do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Do you require cover for outstanding debts? *
Yes
No
i
Outstanding debts sum insured
i
Premises
Include premises?
Yes
No
Postcode *
Find Address
Please select address from the list below
Address line 1 *
Address line 2
Address line 3
Town or city *
County *
What type of property is this? *
(Select)
Commercial
Residential
Business contents cover
Do you own the contents relating to your business? If so, would you like to protect them against loss, theft or accidental damage?
Yes
No
i
Business Contents cover
Yes
No
What is the replacement value of your Computer & Ancillary Equipment (excluding portable equipment used away from the premises)?
i
What is the replacement value of all other business contents (excluding any items of technical equipment used away from the premises)?
i
Rent payable
i
The standard limit for money cover is £1,000, do you want to increase this limit?
Yes
No
Please select the money cover limit
(Select)
£2,500
£5,000
i
Buildings cover
Do you own the building you work from or would you like to protect it against damage?
Yes
No
Do you require buildings cover? *
Yes
No
What is the rebuilding cost of your building? *
i
Do you wish to insure any rental income you receive from this building?
Yes
No
i
How much rental income do you wish to insure? *
i
How many months of rental income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
i
Technical and portable equipment cover
Technical and portable equipment cover
Yes
No
i
Owned Equipment
Technical and portable owned equipment cover
Yes
No
i
Do you require cover for owned portable computer equipment? *
Yes
No
i
What is the replacement value of your owned portable computer equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned technical, photographic & audio visual equipment? *
Yes
No
i
What is the replacement value of your owned technical, photographic & audio visual equipment? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned musical instruments & accessories? *
Yes
No
What is the replacement value of your owned musical instruments & accessories? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Do you require cover for owned props, sets & wardrobes? *
Yes
No
i
What is the replacement value of your owned props, sets & wardrobes? *
Please select geographical Limits of cover required *
(Select)
Own Premises
UK & EU
Worldwide
i
Hired-In Equipment
Technical and portable hired equipment cover
Yes
No
i
Do you require cover for hired technical, photographic & audio visual equipment? *
Yes
No
i
What is the maximum value of hired technical, photographic & audio visual equipment you will have at any one time? *
i
How much do you estimate paying in hiring charges for hired technical, photographic & audio visual equipment during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired musical instruments & accessories? *
Yes
No
i
What is the maximum value of hired musical instruments & accessories you will have at any one time? *
i
How much do you estimate paying in hiring charges for musical instruments & accessories during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you require cover for hired props, sets & wardrobes? *
Yes
No
i
What is the maximum value of hired props, sets & wardrobes you will have at any one time? *
i
How much do you estimate paying in hiring charges for props, sets & wardrobes during the period of insurance? *
i
Please select geographical Limits of cover required *
(Select)
UK & EU
Worldwide
i
Do you ever keep hired equipment on the insured business premises overnight? *
Yes
No
i
Please enter the total sum insured kept at the premises overnight *
i
General technical and portable equipment questions
Does the value of any one single item to be insured exceed £50,000?
Yes
No
i
Business interruption cover
If your insured contents or buildings were to be damaged, or you had restricted access to your building would this impact your ability to continue working?
Yes
No
Business interruption cover
Yes
No
i
What basis of cover do you require? *
Loss of income
Increased cost of working
i
Loss of income sum insured
How many months of loss of income do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Increased cost of working sum insured
How many months of increased cost of working do you wish to insure? *
(Select)
12 Months
24 Months
36 Months
Do you require cover for outstanding debts? *
Yes
No
i
Outstanding debts sum insured
i
Do you require a vehicle to run your business?
Yes
No
Public Liability
Public Liability Cover *
Yes
No
i
What Public Liability indemnity limit do you require? *
(Select)
£2,000,000
£5,000,000
i
Do you have any paid employees?
Yes
No
Do you have any contracted employees?
Yes
No
Do you want to include Employers' Liability cover? *
Yes
No
i
What is the Estimated Turnover of your business for the next 12 months? *
What is the Estimated Wageroll of your business for the next 12 months? *
Work At Height
In the course of your business activities, do you or any person employed by you undertake any work more than 3 metres above ground, floor or stage level?
Yes
No
What is the maximum height in metres above ground, floor or stage level at which you work?
(Select)
4 Metres
5 Metres
6 Metres
7 Metres
8 Metres
9 Metres
10 Metres
Over 10 Metres
Are full risk assessments (which include the use of Personal Protective Equipment and appropriate training) completed prior to the work commencing and are these kept by you
Yes
No
Please provide full details of the risk assessments completed prior to work commencing
Do you comply with the current legislation for work at height e.g.
The Work at Height Regulations Act 2005
or any subsequent legislation
Yes
No
Please provide further information as to why you do not comply with this legislation
Have you and your employees had 3 years previous experience in working at height
Yes
No
Please provide full details of the type of experience, heights worked at and when this was obtained
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
Please please provide full details of the type of training and when this was obtained
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
Please provide full details of the type of training and when this was obtained
Do you or your employees undertake any work using mobile access systems
Yes
No
Are you and all of your employees who use mobile access systems PASMA qualified
Yes
No
Please provide full details of the type of training when this was obtained
Are all of your employees provided with Personal Fall Protection systems including, but not limited to, fall arrest systems, work positioning systems or restraint systems
Yes
No
Please provide full details of the system(s) in place
Have you had any incidents (whether this resulted in a claim or not) as a result of work carried out at height
Yes
No
Please provide the date and full details of the incident(s)
Have you had any previous or ongoing investigations by the Health & Safety Executive or any equivalent body for work carried out at height
Yes
No
Please provide full details of the investigation(s), outcome(s) and the date(s)
Fire & Pyrotechnics
In the course of your business activities, do you or any person employed by you use any form of fire, pyrotechnics or any other process involving the application of heat?
Yes
No
Do you or any person employed by you, have a minimum of 3 years' experience in the activities undertaken?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?
Yes
No
Does any person employed by you undertake performance work involving the use of fire, such as fire eating/breathing?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Hypnotism
In the course of your business activities, do you or any person employed by you perform any routine that involves any form of hypnotism?
Yes
No
Stunts and Hazardous Routines
Does any person employed by you perform any stunts or other routines that may be deemed hazardous (e.g. juggling with edged weapons)?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Animals
In the course of your business activities, do you or any person employed by you undertake performance or work involving the use of any animal?
Yes
No
Do you or any person employed by you, have a minimum of 3 years' experience in the activities undertaken?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?
Yes
No
Do your activities include working with horses?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Do you work with any animals classified under the
Wild Animals Act 1976
?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Do you work with any animal classified under the
Dangerous Dogs Act 1991
?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Black powder & projectile weapons
Do you work with black powder?
Yes
No
Do you or any person employed by you, have a minimum of 3 years' experience in the activities undertaken?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?
Yes
No
Do you work with pistols, canons or guns?
Yes
No
Do you or any person employed by you, have a minimum of 3 years' experience in the activities undertaken?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?
Yes
No
Does your work include archery?
Yes
No
Do you or any person employed by you, have a minimum of 3 years' experience in the activities undertaken?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
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 you or any person employed by you undertake the performance of or tuition of equilibristic circus skills?
Yes
No
Do you or any person employed by you, have a minimum of 3 years' experience in the activities undertaken?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
Are written risk assessments prepared in respect of these activities and can copies of these be supplied if required?
Yes
No
Promotion or organisation of events
Are you involved in the promotion or organisation of events?
Yes
No
Cruise Ships
Do you undertake any performances or work on cruise ships?
Yes
No
Temporary Grandstands / Staging
In connection with any performances staged by you, do you ever erect temporary staging or grandstands?
Yes
No
Is this work carried out by qualified professionals with their own insurance?
Yes
No
Please provide further details below including the nature of activities undertaken, safety precautions undertaken and any relevant qualifications held:
*All fields on this page are mandatory
**At least one of the fields on this page are mandatory