Nightclubs and Entertainments Proposal Form
Introduction

The information you provide on this proposal form is vital to Underwriters' consideration of the relative risks associated with your business. The premium quoted will be based on a number of factors including the responses you give to the questions below.

This proposal must be signed and dated by a partner, principal or director of the business. It is your duty to disclose all material facts to the Underwriters. A material fact is one that is likely to influence underwriters' judgement and acceptance of your proposal.

Should we underwrite your policy, any change or alteration to the information you give below, which occurs during the period of the policy, requires immediate notification to us. Failure to do so may result in cover being available from the date at which the change or alteration occurred.

1. The Insured
1. Full name of Proposer including all trading names, group companies and subsidiaries that are to be covered by the policy
2. Registered Address of the Insured
Post Code
Telephone
Fax
Email Address
2. Trading Name of the Insured
3. Full Business Description
4. Please list names and dates of birth of all Directors/Partners
5. If you require Employers’ Liability cover, please supply your Employer PAYE Reference(s). (This information is required for us to provide Employers’ Liability cover. Where you have more than one PAYE Reference, please advise each one making it clear which company they apply to)
6. If you do not have a PAYE Reference, please confirm that you are exempt and give the reason.
7. How long have you been operating:
  a) at this premises
  b) elsewhere
8. For all new businesses, The 'Financial Questionnaire' at the end of this form must be completed and should be accompanied by a brief CV for each Director, Partner or Principal.

9. Venue web-site address
   
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