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Social Club Quotation Request Form  

We are happy to provide quotations and cover for the following activities/clubs: Working Men’s Clubs, Masonic Lodges, Ex-Servicemen’s Clubs, Political Clubs, Welfare Clubs, Community Clubs, Village Halls. Please contact us for any other type of Club not specified above.

CCV Agency No
Name of Club
Address of Club
Postcode
Email Address
Telephone No
Current Insurers
Renewal Date
Existing Premium
Cover Commencement Date
Invited Premium
Please tell us where you heard about this product?
Sums Insured / Limits Required ( Please show split in sums insured as requested below)
PROPERTY / MATERIAL DAMAGE (* Please advise %ge Day One uplift if required)
Buildings (Standard Construction)* £   Buildings (Non-Standard Construction)*  £
Stands (Standard Construction)* £   Floodlights       £
Stands (Non-Standard Construction)* £   Money in Safe (Out of Hours Business) £
Clubhouse Contents (Furnishings, etc.) £   Bar Stock, Wines, Spirits & Tobacco £
Grounds Maintenance Machinery £   Greens & Pitches £
Computers, Business Machines, TV’s etc £  
(please state type of surface)
Gym Equipment            £   Cups and Trophies (All Risks UK) £
BUSINESS INTERRUPTION
Gross revenue
Book debts (standard policy limit)
Indemnity period (months)
Increased Cost of Working
EMPLOYERS & PUBLIC LIABILITY
Employers Liability Indemnity Limit - £10,000,000
Public Liability Indemnity Limit
£1m £2m £5m
Clerical Wageroll
Groundsmen Wageroll  
Bar/Steward/Others
Wageroll Estimated
Annual Turnover
Number of Club Members

GENERAL INFORMATION
Details Of Construction (Please include age of buildings, type of construction (including walls and roofs) and if there are any listed buildings, please state what ‘Grade’ listing (e.g. Grade I, Grade II etc))
Please advise percentage of Flat Roof? %

Clubhouse

Outbuildings & Stands
Details of Intruder Alarm System (please state what buildings are protected (e.g. Clubhouse/Greenkeepers Store/ProShop, etc.) and the alarm signalling method on each building)
Audible Only   Central Station
Digicom Overground or Underground   RedCARE
DualCom   PAKNET
Other (please detail)
Alarm Company name
NACOSS-approved
Are all outbuildings alarmed?
Are all final exit doors fitted with at least five lever mortise deadlocks, and all accessible windows fitted with key
operated locks?
CLAIMS
Have you made any claims (whether paid or outstanding) in the past 5 years?
If 'Yes' please provide details
Have there been any floods in last 5 years, or flood warning given in the area?
If ‘Yes’, please provide details

Details of all sports played on premises and any other information
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Cover is subject to a satisfactorily completed proposal form.
One of our advisers will be in touch with you about this quotation request very shortly.
Contact us for further information or an appointment
 
 
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