Charity and Association Liability - Quotation Form

Premiums from £260.00

To obtain your quotation please submit the on-line form below * = required field

1. Name and Address of Charity / Association
Contact Name: *
Charity Name:
Address 1:
Address 2:
Address 3:
Town:
County:
Postcode:
Telephone: *
Web site address:
E-mail: *
Date Established
Charity Number
2. Please state type of charity (eg. Trust, Limited Liability Company, Industrial/Provident Society, Unincorporated Association/ Trust, Incorporated by Royal Charter
3. Number of Staff - please state the total numbers of:
Qualified staff
All other staff
Voluntary staff engaged in charitable work other than fund raising
4. Please state the activities/purposes of the Charity/Association
5. Do the Charity/Association's activities/purposes extend overseas?

If YES, please state where and in what manner
6. Income
a. What is the Charity's/Associations total gross income for:
Its last complete financial year
Anticipated for the current year
b. Provide a percentage breakdown of the source of such income between:
Funding from Government, Local Authorities or Government/Local Authority Agencies %
Subscriptions and membership fees %
Voluntary income/donations %
Fee-generating activities %
Other - please give details below %
Total % 100
7. Can you confirm that the Charity/Association's funds are managed by suitably qualified external professional managers?
If YES please answer question a.
If NO please answer question b.
a.Can you confirm that

(i) there has been no change in the external professional managers used within the Charity/Association within the last 3 years?

(ii) the Charity/ Association and/or its Trustees maintain full legal rights against such external professional managers?

If NO please give full details below

b. Please provide full details of who manages the charity's/Associations funds, the length of time they have undertaken such duties and their experience in fulfilling this function
8. Can you confirm that:

a. the Charity/Association's activities are solely confined to fund raising and/or the provision of advice or support to an identifiable group or community, and such advice and support
(i) does not involve providing any form of treatment and/or medical/surgical care or advice?
(ii) does not involve providing any legal, financial or environmental advice?
(iii) does not involve undertaking any scientific or medical research?
(iv) is free of any specific charge or fee and is not the subject of a contract for the provision of professional services?

OR

b. that the Charity/Association is either sports, social or recreational society, association or club?

AND THAT

c. the Charity/Association does not undertake any certification, examination,licensing or regulatory activities or functions?

If NO please provide full details below:
9. Do the activities of the Charity/Association involve either

a. the provision of running of residential homes for, and/or

b. the regular care of, training, supervision or sole charge of persons under the age of 18, or of vulnerable adults, by members, employees or volunteers of the Charity?

If YES please answer the following questions

(i) Please provide full details of the Charity/Association's activities
(ii) Please provide full details of the Charity/Association's policies and procedures to ensure the suitability od such members, employees or volunteers to work with children or vulnerable adults
THEFT SECTION - OPTIONAL
Please complete if cover required
10. Please provide a split of your locations and employees in the UK (please note we are unable to provide cover for the acts of non UK employees)
Number of locations
Number of employees (including working directors) volunteers with responsibility for money and/or stock accounts and/or computer operations
Number of all other employees (including working directors) and volunteers
11. Please state the amount in £ of : (please put 0 if not applicable)
The amount above which all cheques and other bank instruments require two hand-written signatures
The maximum value of stock in any one location
The annual volume of funds transfer instructions given to banks or other financial institutions
12. Do you use your own computer for for electronic funds transfer

If YES please give the total value of electronic funds transferred in your last completed financial year
GENERAL SECTION (Mandatory)
 
13. Current Insurance Information
Name of current Insurer (if any)
Expiry Date of current policy
14. What indemnity limits are required?
Professional liability £
Theft £
     

If you experience problems with the on-line quotation form please contact us

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