Nightclub Insurance Proposal Form

Please leave this field empty.

Date cover required from?

Current insurance held with?

Current insurance premium?

How did you hear about us?

—Please choose an option—AI OverviewChatGPTClaudeGeminiCoPilotMetaGoogle web searchGoogle sponsored resultGoogle AdYahoo web searchBing web searchOther web searchFacebookXLinked InRecommendationExisting clientWord of mouthAdvertisementOther

CONTACT DETAILS

Contact name*

Telephone number*

Email address*

Correspondence address

Town

Postcode

BUSINESS DETAILS

Company name

(Please enter the full name(s) and any trading names as they should appear on policy documents)

Business risk address

Town

Postcode

Website

Type of trade

—Please choose an option—NightclubLate-night barLive music venueLate-night entertainment venueCabaret clubComedy clubVenue with activitiesOther

What is the insured’s trading type?

—Please choose an option—IndividualSole TraderPartnershipLimited Liability Partnership (LLP)Limited CompanyNon-Limited CompanyPublic Limited Company (PLC)Charity OrganisationCommunity Interest Company – CICOther

Date trading since

Number of years trading at this address?

—Please choose an option—0123455+

Number of years trading at a previous address?

—Please choose an option—0123455+

INTERESTED PARTIES

Do you need to note the interest of an interested party?

—Please choose an option—YesNo

YOUR PREMISES

Are the premises all of standard non-combustible construction (walls built of brick, stone or concrete)?

—Please choose an option—YesNo

Do the premises have a roof constructed of slate, tile, metal or concrete, excluding any flat roof area?

—Please choose an option—YesNo

Is any part of the roof flat?

—Please choose an option—YesNo

Does the premises construction have any pre-fabricated insulation panels, composite panels or wall linings?

—Please choose an option—YesNo

Do the premises/buildings have a listed status?

—Please choose an option—YesNo

What year were the premises built?

—Please choose an option—Pre 18501850 – 19201921 – 19391940 – 19791980 – 19891990 – 19992000 & later

How many storeys do your premises have?

—Please choose an option—0123455+

Are the premises in a mill complex?

—Please choose an option—YesNo

Location of premises

—Please choose an option—Business park unitRetail parkIndustrial unitUnit within Iindoor shopping centreSelf-contained premises within multi tenure mill complexStreetsideHigh streetIndoor leisure complexResidentialMulti-tenant buildingOffice blockOther

Do you trade all year round?

—Please choose an option—YesNo

Are the premises you occupy self-contained?

(i.e. with a separate lockable entrance and exit)

—Please choose an option—YesNo

Are the premises solely occupied by the business?

—Please choose an option—YesNo

Is there residential accommodation at the premises other than that which acts as the private dwelling of the proposer or their employees?

—Please choose an option—YesNo

Are the premises occupied by the proposer, or their employees overnight?

—Please choose an option—YesNo

The premises have not had any history of flooding and are in an area free from flooding

—Please choose an option—YesNo

The premises are free from, and in an area (within 400m of the premises) which is free from any signs of subsidence, heave and/or landslip

—Please choose an option—YesNo

The premises have had the electrical installation tested by a certified approved contractor within the last 5 years and all reported defects remedied

—Please choose an option—YesNo

The premises are what distance from the nearest police station?

The premises are what distance from the nearest fire station?

Do the premises have an open fire, woodburning or multifuel stove?

—Please choose an option—YesNo

SUMS INSURED (REINSTATEMENT VALUES)

Buildings

Subsidence cover required?

—Please choose an option—YesNo

Signs

Tenants improvements

Loss of rent payable per annum

Loss of rent payable indemnity period

—Please choose an option—12 months18 months24 months36 monthsNot required

General contents, trade fixtures and fittings

Computers & electronic business equipment (including EPOS systems)

Sound, lighting & entertainment equipment

Property in the open

General stock

This includes all dry stock, frozen foods, soft drinks and beers

Wines & spirits

Tobacco, vapes, E-cigarettes & ancillary equipment

Deterioration of stock

(Frozen or refrigerated stock)

Money (during business hours and in transit)

Money (in locked safe outside business hours)

Money in gaming machines

(total in all machines)

Money in gaming machines

(total in any one machine)

Type of safe

—Please choose an option—No safe on premisesSafe installed in line with the manufacturer’s instructions

Goods in transit

Business interruption cover required

If loss of rent receivable is required, please include in the business interruption figure

Business interruption indemnity period

—Please choose an option—12 months18 months24 months36 monthsNot required

Loss of licence

—Please choose an option—£100,000£150,000£200,000£250,000Not required

LIABILITY

Public liability limit of indemnity

—Please choose an option—£1,000,000£2,000,000£5,000,000£10,000,000Over £10,000,000

Your annual turnover for the forthcoming 12 months

Is cover required for employers' liability?

—Please choose an option—YesNo

VENUE RISK INFORMATION

Is frying undertaken at the premises, other than shallow frying?

—Please choose an option—YesNo

Is there a full frying range (fish & chip shop style) located and used at the premises?

—Please choose an option—YesNo

Are the kitchen and/or canopy hood, range extraction systems and ducting annually maintained and cleaned by a professional contractor?

—Please choose an option—YesNo

Is a pressure cooker used at the premises?

—Please choose an option—YesNo

What is the venue’s seating capacity?

What is the venue's scores on the doors hygiene rating?

Details can be found on www.scoresonthedoors.org.uk

Please note that the rating cannot be transferred from a previous owner

—Please choose an option—Exempt12345Pass & Eat Safe (Scotland)Pass (Scotland)Improvement Required (Scotland)Not yet assessed

Do kitchen areas have a working fire suppression system?

—Please choose an option—YesNo

How are the premises heated?

—Please choose an option—Fixed gasFixed electricFixed oilFixed space heatersHVAC systemHeat pumpSolid fuel burnerCoal or biomass heatingUnderfloor heatingSolar heatingFixed thermal storageFixed infrared heatingFixed LPGNo heatingOther

Do you use portable heaters?

—Please choose an option—YesNo

How many fire exits do the premises have?

Are fire exits maintained, clear, inside and out, at all times?

—Please choose an option—YesNo

Is any part of the business situated in the basement of the premises?

—Please choose an option—YesNo

What is the venue's authorised capacity?

What are the opening hours for each day of the week?

Is there a membership system in place?

—Please choose an option—YesNo

What is the target age of customers?

—Please choose an option—18+21+25+

Do you operate a dress code?

—Please choose an option—No formal dress codeSmart/casual dress codeSmart dress code

Is a charge made for entry?

—Please choose an option—YesNo

Does the proposer hold a current and valid licence(s) to sell alcohol at any of the premises and are not aware of any matters pending that are likely to affect those licences?

—Please choose an option—YesNo

Does the venue offer live music such as DJ's, solo artists, bands, karaoke, etc?

—Please choose an option—YesNo

Does the venue have a dance floor or an area set aside for customers to dance?

—Please choose an option—YesNo

Does the venue provide bouncy castles, foam nights, rodeo rides or other such entertainment that involves customer participation?

—Please choose an option—YesNo

Does the venue offer event hire? (weddings, parties, etc)

—Please choose an option—YesNo

Does the venue use door staff?

—Please choose an option—NoYes – SIA licensed 3rd party agencyYes – SIA licensed own employees

Is there an ATM on the premises?

—Please choose an option—YesNo

Does the proposer have a health & safety policy in place with all appropriate and necessary risk assessments carried out?

Note: The following regulations should be complied with:
Management of Health and Safety at Work Regulations 1999
Workplace (Health, Safety and Welfare) Regulations 1999
Personal Protective Equipment at Work Regulations 1992
Manual Handling Operations 1992
Health and Safety (First Aid) Regulations 1981
The Health and Safety Information for Employees Regulations 1989
The Control of Noise at Work Regulations 2005

—Please choose an option—YesNo

Does the proposer employ a Health and Safety firm to ensure compliance with HSE requirements?

—Please choose an option—YesNo

What facilities are provided for smoking?

—Please choose an option—No onsite smoking facilitiesShisha areaDesignated smoking area

SECURITY RISK PROTECTIONS

Do the proposed premises comply with the minimum security requirements described below?

1) The Final Exit Door of the premises is fitted with either a mortice deadlock / hook lock, which has 5 or more levers with matching boxed striking plate and conforms to BS3621 standard, or a cylinder operated deadlock or a deadlocking multi-point locking system. Timber doors frames to be at least 45mm thick. All aluminium framed doors are to be fitted with a swing bolt type mortice deadlock.

2) All other external doors and all internal doors giving access to any part of the building not occupied by the insured for the purposes of the business, are fitted with either, the security detailed in 1), or two key operated security bolts of doors, fitted approximately 30cm from both the top and bottom of the door.

3) All Cellar Flaps are fitted with the security as detailed in 1), or 5 lever close-shackle padlocks, together with substantial locking bars.

4) All ground floor and basement opening windows and skylights and all other opening windows and skylights, accessible from roofs, balconies, decks, canopies, down pipes or canopies must be fitted with key operated window locks or permanently fixed shut.
Any door or window officially designated to be a Fire Exit by the Fire Authority is excluded from these requirements. These are to be secured internally by panic bolts or fire exit bolts. Any additional devices are to be approved by the local Fire Prevention Officer.

—Please choose an option—YesNo

Do the premises have solid steel shutters, bars or grills to accessible windows?

—Please choose an option—NoneFront onlyBack onlyFront & back

Do the premises have solid steel shutters to external doors?

—Please choose an option—NoneFront onlyBack onlyFront & back

Do the premises have an intruder alarm under the sole control of the insured?

—Please choose an option—NoYes - bells audible onlyYes - digital communicator to keyholderYes - digital communicator to monitoring stationYes - central station monitored dual pathYes - central station monitored single path

Do the premises have an integrated mains wired fire alarm, under the sole control of the insured?

—Please choose an option—NoYes - bells audible onlyYes - central station monitored

Do the premises have CCTV?

—Please choose an option—NoneInternal onlyExternal onlyInternal & external

Do the premises have 24-hour onsite security?

—Please choose an option—YesNo

Do the premises have fire extinguishers installed, maintained & serviced under contract?

—Please choose an option—YesNo

CLAIMS

Have you, the Proposer(s), Partner(s) or Directors(s) suffered a loss, claim or incident (which may give rise to a claim) at these premises, or any other premises, whether insured or not within the last 5 years?

—Please choose an option—YesNo

ADDITIONAL INFORMATION

Do you want to bring any further information or material facts to the underwriters attention?

—Please choose an option—YesNo

DISCLOSURE

Disclosure: Please ensure that the information provided by the Proposer and the statement on these pages are correct and that you disclose material circumstances to make a fair presentation of the risk. Should the Proposer decide to proceed with the quotation, these details will form the basis of the insurance contract. Incorrect information could invalidate all or part of the Policy. Please confirm that the Proposer agrees to the following statements:
When answering all questions, you are confirming on behalf of the Proposer that the statements are true and if this quote is converted to an insurance policy, it will form the basis of any contract of insurance affected thereon.

Neither the Proposer, nor any directors or partners in the business either personally or in connection with the business or in any other business capacity has ever:

- had an insurance contract cancelled by an insurer

—Please choose an option—YesNo

- had an insurance contract declared void by an insurer

—Please choose an option—YesNo

- had different terms applied to an insurance contract by an insurer due to misrepresentation by:

• a) providing misleading or incorrect information

• b) deliberately or recklessly withholding information

• c) providing false documents

—Please choose an option—YesNo

- had insurance cover restricted or cancelled due to non-compliance with risk improvement requirements

—Please choose an option—YesNo

- been convicted of or charged with but not yet tried for a criminal offence other than motoring offences

NOTE: Spent convictions (as defined under the Rehabilitation of Offenders Act 1974 or any similar or subsequent legislation) do not need to be declared.

—Please choose an option—YesNo

HEALTH & SAFETY

Neither the Proposer, nor any directors or partners in the business either personally or in connection with the business or in any other business capacity has ever been:

- convicted of (or charged but not yet tried with) a breach of any UK health and safety legislation by any official body regulatory authority or enforcing authority

—Please choose an option—YesNo

- served with a prohibition notice or improvement notice in connection with any UK health and safety legislation by any official body regulatory authority or enforcing authority

—Please choose an option—YesNo

- served with a clean-up notice in connection with any UK health and safety legislation by any official body regulatory authority or enforcing authority

—Please choose an option—YesNo

- All lifting plant and pressure vessels/boilers which are subject to Statutory Regulations are regularly inspected by qualified engineers as required by the legislation

—Please choose an option—YesNo

- To the best of their knowledge the proposer complies with their legal obligations under UK health and safety legislation

—Please choose an option—YesNo

FINANCIAL

Neither the Proposer, nor any directors or partners in the business or in the name of any other business which any of us had an interest have:

- been declared bankrupt or insolvent either as private individuals or in connection with any business

—Please choose an option—YesNo

- been disqualified from holding a directorship

—Please choose an option—YesNo

- been the subject of a County Court Judgement (or the Scottish equivalents) in respect of debt as private individuals or in connection with any business

—Please choose an option—YesNo

- been a director or partner in a business that has been the subject of a County Court Judgement (or the Scottish equivalents) in respect of debt

—Please choose an option—YesNo

- been officers of a company that has been declared insolvent, or had a receiver or liquidator appointed, or entered into arrangements with creditors in accordance with the Insolvency Act 1986

—Please choose an option—YesNo

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