A SAMPLE OF THE PROPOSAL FORM

PROPOSAL FORM
for
PUBLIC ENTERTAINMENTS,
CONCERT AND SIMILAR EVENTS



THE INSURANCE ACT: You are to disclose ion the proposal form fully and faithfully all the facts you know or ought to know otherwise the policy issued hereunder may be void.



1. Name of Persons, Committee or Authority in whose favour insurance is
required..............................................................................................................

2.Address............................................................................................................

3.(a)Date of event.....................................................................................
(b) Number of days involved (allow for setting up and dismantling).........
(c) Full particulars of the event including where it is to be held.................
(d) Anticipated attendance....................................................

4. Are any grandstands or street decorations to be erected?......................
If so-(a) Will these be approved by the Local Authority?............................
(b) What will be the capacity of the grandstands?........................................
(c) By whom will they be erected?..................................................................

5. Is there to be a car park?.............................................................................
If so-(a) What will be maximum capacity?.....................................................
(b) Will any charge be made?..................................................................
(c) Will tickets be issued?........................................................................
(If so please attach a specimen)
(d) Will any notices be displayed disclaiming liability?.......................
(If so please attach wording)

6. Will adequate precautions be taken to protect the public from any dart
throwing, rifle shooting or similar side shows?...............................................

7. Is there to be a display of fireworks?...............................................................
If so-(a) Will this be operated by independent contractors?.........................
(b) What precautions to avoid injury will be taken?.............................

8. Please state-
(a) Limit of Indemnity required.............................................................
(b) Whether insurance is required against liability arising out of:
(i) Damage to property by fire and explosion.................................
(ii) Personal injury caused by fireworks..........................................
(iii) Car park for which a charge is made..........................................



Declaration:

I agree that this proposal shall form the basis of the contract between me and ABC Insurance Company and I am willing to accept a policy subject to the terms prescribed by the company therein and to pay the premium thereon.




Date..........................................


Signature of Proposer............................................