1. Employers Liability
Is cover required for Employer's Liability?
Yes  No
If Yes, please provide the following details:
  Type of Employee
Number
Estimated Wages
  Clerical/Managerial
  Door Supervisor/Security Staff
a) Sub Contractors:
   (i) Do you employ any Sub Contractors? (If Labour only please include under Employers Liability section)
Yes  No
   (ii) Do you ensure that Bona Fide Sub Contractors maintain Employers Liability and Public/Products/Products Efficacy Liability Insurances with Limits of Indemnity no less than the Limits Proposed under this Insurance
Yes  No
   (iii) Estimated Annual Payments to Bona-Fide Sub Contracts
£
2. Public Liability
What Limit of Indemnity is required?
£
Is cover required for Public Liability?
Yes  No
Annual estimated turnover
£
3. Wrongful Arrest
Is cover required for Wrongful Arrest?
Yes  No
4. Directors and Officers
Is Directors and Officers cover required?
Yes  No
5. Personal Accident
Is cover required for Personal Accident?
Yes  No
(a) Number of persons to be insured
(b) Are you and your staff physically fit and in good health?
Yes  No
If No, please provide brief details
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