Large Event Insurance Form

General liability cover for events such as festivals, music events, fairs, theatre productions, exhibitions, conferences etc

Information needed to quote

Full Name

ABN (If registered)

Email Address

Contact Number

Event Date

Start Time & Finish Time

Event Address

Please describe business activities to be insured in as much detail as possible:

Please indicate which best describes your business activities:

Entertainer / Performers / Musician / Band etcTheatre / Performance GroupDrama / Dance SchoolCircus / Aerial TuitionEvent Manager / Coordinator / Wedding &/or Party PlannerEvent Promoter / Event Owner / Event PrincipalMarket OrganiserIndividual Stallholder / Exhibitor at third party eventCommunity Group / Not-for-Profit OrganisationBooking AgencyPublic Address, Sound, Lighting, Audio Visual, Staging or Rigging activitiesFilm & Video ProductionPhotographerOther

Address(es) of where you will be predominantly carrying out your business activities

Estimated Gross Turnover for the next 12 months

If cover is only required for a short-term period or one-off event, please provide estimated turnover or budget for the short-term period or one-off event:

Estimated Wages paid for next 12 months:

Number of employees:

Do you engage subcontractors or contractors?

YesNo

Estimated payments to contractors/subcontractors:

Do you insist all contractors/subcontractors have their own liability insurance?

YesNo

Do you engage voluntary/unpaid workers?

YesNo

Do you require cover for any activities outside of Australia?

YesNo

Number of years your business has been in operation or your experience in this field:

Will you be signing any contracts that contain hold harmless or indemnity agreements?

YesNo

Will you require cover for liability claims arising from loss or damage to other people’s property whilst in your care, custody, or control?

Yes – Automatic $250,000 includedNo

Sum Insured Required:

Public Liability

10,000,00020,000,000

Additional Information

Has any insurer ever declined to insure you or declined to renew any of your insurances or imposed special terms and conditions?

YesNo

In the last 10 years, have you ever had any criminal convictions or been bankrupt?

YesNo

In the last 10 years, have you suffered any public liability claims or caused incidents that could give rise to a public liability claim?

YesNo

Have you previously been insured for liability?

YesNo

If you answered yes to any of the above, please provide details: