1a.
Please select the amount of Liability cover required:
1b.
1c.
Property in Care Custody and/or Control (Premises, Vehicles, Employees Property, other Property excluding keys, money and documents) Limit of Liability:
$
1d.
Total amount of Money and Documents carried during this year:
$
1e.
Loss of Money and Documents Limit of Liability:
$
1f.
Loss of Keys Limit of Liability:
$
1g.
Errors and Omissions Limit of Liability:
$
2.
Do you currently have Public Liability insurance?
If Yes, please provide details below:
Expiry Date
Insurance Company
Indemnity limit
$
Excess
$
Premium
$
3.
Name of Partners/Directors:
4.
Background of Partners/Directors:
5.
Are you a member of a security association?
If Yes, please provide details:
6.
Date established:
7.
Number of full time staff:
8.
Number of part time staff:
9a.
Actual Turnover for last year:
$
9b.
Estimated Turnover for this year:
$
10a.
Actual Wages for last year:
$
10b.
Estimated Wages for this year:
$
11.
What percentage of turnover is derived from the following:
12.
Do you use sub-contractors? Please note: Any and all subcontractors whose services are used by the Insured are deemed NOT to be Employees and shall provide their own liability insurance in an amount as least equal to this insurance or a greater Limit of Liability as required by the Insured.
13a.
Do you provide guard dog security?
If Yes, please state:
13b.
Total number of dogs:
13c.
Are dogs permanently under control of handler?
If No, please provide details:
13d.
Are all dogs properly kenneled when not being used for guard duty?
13e.
Are all dogs professionally trained prior to being used for guard duty?
14a.
Do you use firearms?
If Yes, please state:
14b.
What percentage of your turnover is derived from gun use?
%
14c.
Number of guards licensed to use guns?
14d.
Number and type of firearms used?
14e.
Are firearms serviced each year?
14f.
How often is shooting practice undertaken each year and provide details:
14g.
Confirm all firearms are licensed and is copy of Licence sighted?
14h.
Confirm all guns are stored, when not in use, under government approved storage conditions?
15a.
Do you use batons?
If Yes, please state:
15b.
Number and type of baton used?
15c.
Please provide details of training undertaken:
16a.
Do you provide warning signs or notices?
If Yes, please state:
16b.
Types of signs/notices:
16c.
Are signs well posted and open to full display?
16d.
Do you display signs at minimum distances?
17a.
Do you have a clear protocol and security for the locking of keys out of hours?
Please provide details:
17b.
Is a record kept of who has swipe card access and times used?
Please provide details:
17c.
Is any re-keying done with your knowledge?
Please provide details:
18.
Do you provide any indemnities, hold harmless conditions to any customers, suppliers or other parties?
If Yes, please provide the details or attach a copy of the contracts:
19.
Do you contract to any State, Federal Authorities or Airports?
If Yes, please provide full details:
20.
Do you provide and Medivac services?
If Yes, please provide full details:
21.
Have you in the past, either alone or in partnership or jointly with any party, or if a corporation any of its directors:
21a.
Suffered any loss, destruction or damage for risks to be insured under the proposed policy?
21b.
Had any insurer decline any claims submitted?
21c.
Had any insurer decline any Proposals submitted?
21d.
Had any insurer cancel or refuse to renew a Policy?
21e.
Had any insurer require any increased premium or imposed special conditions?
21f.
Every been bankrupt?
21g.
Been convicted of or charged with any civil or criminal offence?
If you answered Yes, to any of the above, please provide full details:
22.
Detail all insurance claims made in the last five years together with any uninsured losses. Please include dates and amounts: