On-line Events Liability Insurance


Thank you for considering our on-line events liability insurance service.   Because Greater National Group is an insurance broker, not an insurance company, we will process your application with major insurance companies in order to find the right events liability insurance deal.

Please fill in the following form as fully as possible, then click 'submit' at the end of the form.
You can use the TAB key to move to the next field. We will respond with your terms as soon as we have researched the market for the right available deals that fit your requirements.


Limit of Liability Required:
1a. Please select the amount of Liability cover required:
$5,000,000 $10,000,000 $15,000,000 $20,000,000
1b.
Public Liability (any one occurrence)
Products Liability (each Period of Insurance)
2. Do you currently have Public Liability insurance?
No Yes
If Yes, please provide details below:
Expiry Date
Insurance Company
Indemnity limit $
Excess $
Premium $
Company Details:
3a. Type of Business/Occupations
3b. Fully describe your business activities in detail:
How many years operating:
3c. This business? Years
3d. Other business? Years
3e. Address(es) of branch office/depots/operating bases:
3f. Has any Insurer ever declined or refused to renew or canceled or imposed special terms of conditions to any proposed insurance by You?
No Yes
If Yes, please give details:
3g. Please provide details of all claims made against You or incidents reported to You that may give rise to a claim:
Financial Information:
4a. What is your estimated annual revenue turnover? $
4b. What is your annual payment to subcontractors? $
4c. What is estimated annual payroll including earnings of principals, directors, partners? $
Role Payroll No. of Staff
Managerial, Clerical and Sales
Manufacturing
Installation
Other
Total
General Information:
5. Name of Event:
6. Type of Event:
7. Dates of Event (include set-up & dismantle): From    To 
8. Location of Event:
9. Period of Insurance (The inception of the insurance can take effect prior to the beginning of the event): From    To 
10. Do you require cover for an Event, or part of an event, outside Australia?
Yes No
If Yes, please provide:
Which countries:
Dates of Event(s):
11. Are you aware of any circumstances which could give rise to a claim?
Yes No
If Yes, please provide details:
Public Liability:
12. Have you assumed any liability by agreement and which such liability would not have attached in the absence of such agreement?
Yes No
If the answer to the above is Yes, please provide details:
13a. Are pyrotechnics, lasers or explosives to be used during the event?
Yes No
If Yes, please provide details of how and when these will be used:
13b. Who will be responsible for this part of the event?
13c. Do they have their own Public Liability Insurance?
Yes No
14. How many people are expected to attend the event?
Please provide the following security details:
15a. Will security personnel be present?
Yes No
If Yes, who is responsible for their actions?
15b. Do they carry their own Public Liability Insurance?
Yes No
Cancellation, Abandonment and Postponement:
16. Is cancellation, abandonment and postponement cover required?
Yes No
17. Are any parts of the event to be held:
a. Outdoors?
Yes No
b. Under Canvas?
Yes No
If Yes, to either a) or b), please provide details, including exact location:
18. Will adverse weather conditions prevent the fulfillment of the event?
Yes No
If Yes, please provide details of the type of weather:
19. In the event of damage to the venue, are alternative venues available?
Yes No
If Yes, please provide details:
20a. Does the event depend upon the appearance of a Performer, Act, Group or Speaker?
Yes No
20b. If Yes, do you require cover in the event that the Performer, Act, Group or Speaker is unable to appear or perform?
Yes No
If Yes, please advise:
Name(s)
Ages(s)
Travel Arrangements
Details Of Understudies
21. Have all arrangements been made in order to carry out this event?
Yes No
22. Have you had any previous experience in staging this kind of event?
Yes No
If Yes, please provide details of previous events:
23. Breakdown of the sum to be insured:
a. Costs and Expenses $
b. Guarantee and Commitments $
c. Sponsorships $
d. Merchandising $
e. Television/Media Revenue $
f. Net Profit $
g. Other Expenses $
24. Does the above sum represent the full value at risk?
Yes No
25. Do you require the extension for Failure to Vacate the venue?
Yes No
If Yes, please provide a Sum Insured: $
26. Do you require Additional Expenses cover?
Yes No
If Yes, please provide a Sum Insured: $
Property All Risks:
27. Is property all risks cover required?
Yes No
If Yes, please provide:
Value of Equipment owned: Electronic $ Other $
Value of Equipment hired: Electronic $ Other $
Money Insurance:
28a. Is this cover required?
Yes No
If Yes, please provide details:
28b. What is the maximum estimated amount that will be carried in any one transit? $
28c. What security precautions will be taken?
28d. Please indicate the period this cover is required for: From    To 


Duty of Disclosure:
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Yes No
If so, please provide details:
I/We hereby declare that:
My/Our attention has been drawn to the Important Notices accompanying this form and further I/we have read these notices carefully and acknowledge my/our understanding of their content. The above statements are true, and I/we have not suppressed or mis-stated any facts and should any information given by me/us alter between the date of this form and the inception date of the insurance to which this relates I/we shall give immediate notice thereof. I/We authorise GNG and the Insurer to collect or disclose any personal information about another individual (for example, an employee, or client), I/we declare that the individual has been or will be made aware of that fact and the Privacy Policy. I/We also confirm that I/we am/are authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this form and I/we complete this form on their behalf.
Any other comments, requests or relevant information you need to add:
Contacting you about your quote:
In order to select the most appropriate cover for you, it may be important to discuss quote details in person. Please leave a contact phone number and best time to call to facilitate this.
Your full name:
Company/Business/Name of Applicant to be Insured:
ABN:
Your phone number (please include area code):
Your mobile phone number:
Best time(s) to call:
Please send my quote by (select at least one):
email phone fax mail
Your email address:
Your website address:
Your fax number:
Your postal address:
Country: