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Please note the completion of this form does not bind you or us to enter into a contract of insurance. In order to minimise the need for further clarification please answer all questions fully.

Proposer

£

Core Cover

Parish Protect has been designed specifically for Parish Councils. Please ensure the package you select provides the levels of cover required to adequately protect your Council.

Cover Package All Risks (See 1 Below) Public Liability (See 2 Below) Officers Indemnity (See 3 Below) Fidelity Guarantee (Dishonesty) money Business Interruption (See 5 Below) Personal Accident (See 6 Below) Employers’ Liability Commercial Legal Liability Hirers' Liability (See 7 Below)
1A £5k £10m £1m £25k (See 4 below) £5k £25k £10m £100k £2m
1B £5k £10m £1m £50k (See 4 below) £10k £25k £10m £100k £2m
1C £5k £10m £1m £100k (See 4 below) £15k £50k £10m £100k £2m
1D £5k £10m £1m £250k (See 4 below) £20k £50k £10m £100k £2m
  1. All Risks/Property includes office contents
  2. Public liability including libel and slander at a £250,000 limit
  3. Officials Indemnity includes cover for committee members legal liability
  4. Money: Non-negotiable £250,000, In transit £2,000, Private residence £250, Premises £2,000, Locked safe £2,000
  5. Business Interruption includes standard extensions agreed in policy wording
  6. Personal Accident includes employees, volunteers, committee members
  7. Hirers’ Liability - fee income capped at £5,000 p.a

ALLRISKS/PROPERTY excluding buildings (UK wide cover)

If core All Risks/property limit of £5,000 is insufficient increased limits are available as below. Please indicate the cover level required.

The level selected should reflect the value required to reinstate all assets as new including contents in buildings

All Risks/property include the following (this is not an exhaustive list):

Play, Skate and Sports:

Playing Surfaces, playground equipment, outside gym equipment, skate park equipment, Sports Courts & Associated Equipment.

Outdoor Equipment:

bus shelters, bus stops, christmas decorations, defibrillators, flagpoles, garden furniture/market stalls, gardening equipment (including power tools), noticeboards, signposts, name signs, plant-holders, plate glass/shop front signs, portacabins, portaloos, public seats & benches, refuse bins, floodlights, external lighting (including street lighting), surveying equipment, telephone boxes (being used libraries, noticeboards etc.), walls, fences, ornamental gates, weather appliances.

Civic regalia, antiques:

antique furniture, civic regalia, cups, trophies, musical instruments, paintings, works of art.

Office, Computer, Audio Visual, Photographic Equipment:

audio/visual equipment, computer equipment including laptops, domestic appliances/kitchen equipment, games consoles, mobile phones, pagers, office machinery, photographic equipment, stage lights and sound/PA equipment, speed guns, vending and gaming machines, CCTV equipment.

Other:

memorials, statues, monuments, books, games, toys, stock, models, non-mobile plant, trailers, tools, bicycles, boats, caravans, shop mobility wheelchairs, quad bikes, tractors and other off-road vehicles.

Property Damage

Cover includes Standard Perils, Theft, Accidental Damage & Subsidence

Are all the buildings:-

If you have answered no please provide details in the Additional Information box

Address & postcode of building (if listed what Grade). Occupied as e.g Village Hall/Parish Office Buildings (Sum Insured) Contents (Sum Insured) Intruder Alarm (& signalling if known)
£
£
£
£
£
£
£
£
£
£

Terrorism

Employers Liability


If Yes provide details in the Additional Information box

Claims

£
(Please provide full details in the Additional Information box)
£

Public Liability - Events


If Yes we will require specific please provide details of the event and number of attendees.

If Yes please provide details including – number of attendees and whether a specialist pyrotechnic company is employed. HSE Guidance of fireworks must be adhered to at all times:
  • For professional displays see: HSE Guidance HSG 123 "Working Together on Fire Work Displays
  • For policyholder organised displays see: HSE Guidance HSG 124 "Giving your own firework display"

If the Council holds an event where any of the following apply please request a Parish Council Event Questionnaire to complete:

  • Number of entrants/participants exceeds 750 at any one time
  • Event is to be located outside of the UK
  • Event lasts in excess of 72 hours
  • Cover is required for an event completely organised by a third party
  • Any fireworks display with more than 100 anticipated attendees at the event should be arranged by a professional fireworks contractor who holds their own insurance with an indemnity limit of at least £10,000,000. Where the contractor holds a lower limit of indemnity details need to be referred.
  • Event involves any of the following activities:
    • Weapons
    • Passenger carrying amusement devices
    • Animal rides
    • Aerial activities including parachuting, paragliding or ballooning
    • Go-karting, quad biking or motor sports
    • Bungee jumping
    • Professional sports team or persons
    • Racing or time-trials other than on foot
    • Activities involving watercraft
    • Individual exhibitions valued at over £250,000
    • Inflatable devices (where not operated by Sub-contractor who holds their own Public Liability insurance with a minimum £10 million limit of indemnity)

Declaration