Get A Quote - Parish Protect

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

Name of Parish Council*

Name of Contact

Contact Address

Postcode

Telephone Number

Mobile Number

Email Address

Website

Renewal Date

Current Renewal Premium

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

All Risks/Property includes office contents
Public liability including libel and slander at a £250,000 limit
Officials Indemnity includes cover for committee members legal liability
Money: Non-negotiable £250,000, In transit £2,000, Private residence £250, Premises £2,000, Locked safe £2,000
Business Interruption includes standard extensions agreed in policy wording
Personal Accident includes employees, volunteers, committee members
Hirers’ Liability - fee income capped at £5,000 p.a

Please indicate Core Package required*

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.

Sum Insured 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:-

a) Built of brick/stone/concrete/ steel/non-combustible material & roofed with slates/tiles/steel?

b) Not built of an Airey construction (e.g. pre-fab ‘cornish’ unit)?

c) In a good state of repair?

d) Not listed (if listed please stipulate Grade)

e) Not unoccupied/not in use? (other than seasonal)

f) Free from damage caused by flooding or subsidence, landslip or heave?

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

Is cover required for Terrorism?

Employers Liability

Employers Reference Number (ERN) OR confirm exempt

Any manual work by employees or volunteers?

Any Employers Liability claims made in the last 3 years?
If Yes provide details in the Additional Information box

Claims

Number of losses suffered or claims made in the last 3 years

Total cost of claims (paid & reserves) for all claims within the last 3 years

(Please provide full details in the Additional Information box)If there are claims in the last 3 years please also confirm the total premium paid over the last 3 years (excluding IPT)

Public Liability - Events

Does the Parish Council hold events with more than 750 attendees?
If Yes we will require specific please provide details of the event and number of attendees.

Does the Council hold a Firework or Bonfire event?
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"

Does the Council set up and supervise bouncy castles or inflatables equipment at events?

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

Declaration Name*

Additional Information