Q1) If you are a sole Director or Principal:
Is this a part-time occupation:
Details of all Principals, Partners & Directors
If a principal has less than 5 years relevant experience, please email us a CV.
Q2) Do you currently have Professional Indemnity Insurance in force?
This policy will not cover work undertaken prior to inception of the Policy unless the retroactive date has been advised.
Q3) Please list your largest 3 projects undertaken since business established:
What is the largest fee received in the last year and from which client:
Your business activities
Please split your last complete financial year turnover between the following professional activities
Does the above split accurately reflect (a) your business activities in the past and (b) estimated business activities in the future?
Q4) Are you members of any Trade Association or Professional Body e.g. Chartered Society of Designers?
Please indicate the % of your work which is design only in comparison to project were you arrange for manufacture / production
Do you wish to extend Cover to include:
Do you always prepare a written specification for your client for each project incorporating “ signing off “ procedures?
Are all changes to the specification contract recorded?
Do you always obtain final client sign off before production?
(Please email us a copy of Standard Terms and Conditions)
Q5) Please give details of the Numbers of staff and projected payments to:
Q6) Business Relationships
Is the company or any individual connected or associated (financially or otherwise) with any other company or organisation for whom work may be undertaken for or in connection with the proposed?
Are you a member of a consortium or engaged in any single project partnership?
Do you require sub-consultants to carry Professional Indemnity Insurance?
Underwriters retain rights of recourse against sub-contractors unless specifically agreed otherwise.
Q7) Limits of Indemnity - Please tick level required
Professional Indemnity Standard
Employer Liability £10,000,000 Standard Level
Has any Insurer every declined to offer renewal terms ,imposed special terms or cancelled Cover for the Firm or Principal, Partner or Director
Has any prosecution, prohibition notice or improvement order been made against you under the Health & Safety Legislation during the last 5 years.
Are any of your Principals/Partners aware “after full enquiry” of any circumstances, which may give rise to a Claim against the Firm.
Have any claims been made against you in the last 5 years (or pending) in respect or risks to be covered by the Insurance.
Are you aware of any shortcoming in your work for a client which is likely to lead to a claim against you? This includes (a) a shortcoming known to you, but not your client, which cannot reasonably put right (b) a compliant from your client about your work or anything you have supplied which cannot be immediately resolved (c) an escalating level of compliant from your client on a particular project (d) a client withholding payment due to you after any complaint.
IMPORTANT NOTICE CONCERNING DISCLOSURE
In completing this Proposal you must disclose all materials facts, i.e. those which an Insurer would regard as likely to influence the assessment or acceptance of the risk. Failure to do so could invalidate the Insurance. If you are in doubt as to what facts are material you should, for your own protection, disclose them.
I/We declare that to the best of my/our knowledge and belief the information given in this Proposal is true in every respect.
I/We agree that this Proposal should be the basis of the contract between me/us and the Company and to accept the Company’s Policy applicable to the Insurance.
I/We declare that if anything on this Proposal was written by another period he/she acted as my/own Agent for this purpose.
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