Groups, Societies & Associations

Richardsons

IOMST in conjunction with Insurers, AIG and Brokers, Richardson Insurance Solutions are delighted to announce that it is now in a position to provide market leading coverage for Community groups at extremely competitive prices.

Our facility not only provides increased levels of cover at a reduced cost but also provides a number of additional member benefits.

Simply call us on 01-8360945 Email info@iomst.ie or Fill in our application form below.

* Required

Organiser/ Point of Contact

Name in Full:
*

Group Name:

Address:
*

Phone/Mobile:
*

Date of Birth:
*

Email:
*

Event Details

Please advise the number of events.

Please advise the Maximum attendance .

Please advise the Number of days of cover required. (include dates if possible).

Details

1. Please advise the type of events and activities taking place.

2. Do you hold, or have you previously held, Public Liability?
*
If yes, please give the name and address of the insurer and the renewal date of the policy.

3(a). Do you require an Event Licence?
*
If YES, has one been granted?.

3(b). Have the police been notified?
*

3(c). Have the Fire Authorities been notified?
*

3(d). Have provisions for First Aid been made?
*

3(e). Please advise the number of Stewards provided.
*

3(f). Have you prepared a Safety Statement?.
*

Safety Statement- Required[

3(g). Have you appointed a Market/event Safety Officer?
*

3(h). Do you provide camping or car parking facilities?
*

If yes, please give details.

3(i). Do you use a professional security company to provide crowd control, stewarding/security?
*

If yes, please give details.

3(j). Is a road closure in place (Residential area)?
*

Amusements & Attractions

4(a). Is there a funfair forming part of your event?
*

If yes, please note that the funfair is not covered by this insurance so you must obtain from the funfair’s operators an insurance certificate and engineers report for each ride/attraction.

4(b). Is there a fireworks display forming part of your event? *

If Yes, please attach a copy of their insurance certificate.

4(c). Are there any bouncy castles or other inflatables forming part of your event?
*

If yes, please attach a copy of their insurance certificate.

Cover Required

5. Please confirm the cover required.

Public Liability

Employers Liability (not included in cost of Public Liability)

If yes, state maximum amount of employees/helpers (cover is recommended)

Products Liability - Applies to food and drink products only

(available only with Public Liability) N.B. In respect of food units please provide a photograph with your proposal.

Products Liability is available for other products. Please provide full details so this can be considered.

6. Have you ever been convicted/ charged with a criminal offence (excluding motor)?
*
If yes, please provide details.

7. Has any insurer ever declined a proposal, cancelled or refused renewal or required special terms on any of the insurances for which you are now proposing?
*
If yes, please provide details.

8. Have you suffered any claim or loss (whether insured or not) in connection with Employers, Public or Products Liability over the last 3 years?
*
If yes, please provide details.

	Name of Incidents	Paid/Oustanding
Employers Liability
Public or Products Liability

Our limit of indemnity for Employers Liability is € 13,000,000.
Our limit of indemnity for Public or Products Liability is € 13,000,000.
Products Liability €13,000,000 automatically applies to food and drink. Other products can be included where agreed by insurers.

I/we declare that the statements and particulars given in this proposal are, to the best of my/our knowledge and belief, true and complete and that this proposal will form the basis of my/our membership of IOMST.*Please Agree to Proceed

I/we confirm that I/we am/are giving my/our permission for the information we provided in this form to be used for the purposes set out in the Data Protection section https://www.iomst.ie/iomst-privacy-policy.

Please note that the details you are being asked to supply may be used to provide you with information about other products and services from third parties. The fact that you choose not to receive such information will not affect any aspect of the facilities that are provided to you now or in the future.