Hot Food &/or Tea & Coffee
Application Form

Please select type of membership

—Please choose an option—Member + (one location only)Membership ++ (Annual)

Please complete all fields.:

Proposed Member Details

Name in Full:

Trading Name:

Company Name:

Address:

—Please choose an option—Co AntrimCo ArmaghCo CarlowCo CavanCo ClareCo CorkCo DerryCo DonegalCo DownCo DublinCo FermanaghCo GalwayCo KerryCo KildareCo KilkennyCo LaoisCo LeitrimCo LimerickCo LongfordCo LouthCo MayoCo MeathCo MonaghanCo OffalyCo RoscommonCo SligoCo TipperaryCo TyroneCo WaterfordCo WestmeathCo WexfordCo WicklowDublin 1Dublin 2Dublin 3Dublin 4Dublin 5Dublin 6Dublin 7Dublin 8Dublin 9Dublin 10Dublin 11Dublin 12Dublin 13Dublin 14Dublin 15Dublin 16Dublin 17Dublin 18Dublin 19Dublin 20Dublin 21Dublin 22Dublin 23Dublin 24

Phone/Mobile:

Date of Birth:

Email:

Where did you hear about us:
—Please choose an option—From a FriendI was a memberOnlinePart of a GroupEvent OrganisersOther

If not mentioned above, please provide were you heard about us.

Trading Details

1. Please provide full details of business, goods sold/ services and/or activities:

2. Do you hold, or have you previously held, Public Liability?
—Please choose an option—YesNo

If yes, please provide the name and address of the insurer and the renewal date of the policy.

Name: Expiry Date:

3. Which of the following best describes your business.—Please choose an option—Market/Event/Street TraderArtist selling their own art workCraft Trader selling their own hand made craftsEvent Trader onlyEvent Caterers (no food unit, Private events)Trade Stand onlyDisplay stand onlyInformation stand only (no selling of goods)Horticultural GrowersKiosk (Shopping Centres)Pop-up Shops(short term fix premises)Private Parties/EventsCar Wash ValetOther

If other, please advise.

3(b). Do you trade at one location only or different locations throughout the year.

Trading from one location only
Trading at all locations

If you attend just one location please provide the location

Photo of unit – Required for hot food traders & ice-cream vans.
(Please note: If the photo size is to big the form will not send. Please resize or attach in a separate e-mail)

4. If attending a market/event, please provide name(s) of market/event(s) attended.

5. Cover required for selling. —Please choose an option—Tea, Coffee, Soup, Hot chocolate onlyHot-Dogs OnlyHot Food – no deep fryingHot foodOther If other, Please give details.

Please select which of the following you will be using.
Coffee MachineBurcoGrills’FryersGeorge FormanToasterGas pizza ovenElectric OvenHobHot PlatesBan marieCharcoal BBQElectric BBQGas BBQRice cookerOther (Please advise)

5b. Other please advise,

6. Do you provide any additional services.
1. —Please choose an option—No Additional serviceClasses (please describe class activities below)Fixed premises (shop, pop-up shop,etc.. please provide the size of the shop/unit below)Web-sales (please provide the turnover in relation to sales online below)Polytunnels/garden area (please provide the size of the area below)Supply of your products for re-sale to other 3rd parties(please provide the turnover in relation to re-sale below)Demonstrations/ in-store samplingOther (please provide details below)
2. —Please choose an option—No Additional serviceClasses (please describe class activities below)Fixed premises (shop, pop-up shop,etc.. please provide the size of the shop/unit below)Web-sales (please provide the turnover in relation to sales online below)Polytunnels/garden area (please provide the size of the area below)Supply of your products for re-sale to other 3rd parties(please provide the turnover in relation to re-sale below)Demonstrations/ in-store samplingOther (please provide details below)
3. —Please choose an option—No Additional serviceClasses (please describe class activities below)Fixed premises (shop, pop-up shop,etc.. please provide the size of the shop/unit below)Web-sales (please provide the turnover in relation to sales online below)Polytunnels/garden area (please provide the size of the area below)Supply of your products for re-sale to other 3rd parties(please provide the turnover in relation to re-sale below)Demonstrations/ in-store samplingOther (please provide details below)
4. —Please choose an option—No Additional serviceClasses (please describe class activities below)Fixed premises (shop, pop-up shop,etc.. please provide the size of the shop/unit below)Web-sales (please provide the turnover in relation to sales online below)Polytunnels/garden area (please provide the size of the area below)Supply of your products for re-sale to other 3rd parties(please provide the turnover in relation to re-sale below)Demonstrations/ in-store samplingOther (please provide details below)
If other additional services, please give details.

7. Please advise the number of stalls/units/locations owned/operated by you at any one time.

(Please advise the maximum number of stalls /units you have per Trading Day)
Once your trading area is connected to each other no gaps this is considered to be one stall/unit it would just be a bigger stall/unit. However, if you have a second table/stall or unit with a gap between them or at a different location at the same time as the first then you would require a 2nd stall/unit covered under the policy.

8. Length of cover required. —Please choose an option—Annual 12 months

If you know the date you would like cover to be effected from, please advise.
Please note cover cannot be back dated.

Declaration

9. Please confirm the cover required.

Public Liability—Please choose an option—YesNo

Products Liability – food and drink products only—Please choose an option—YesNo

Non-food Product Liability for none-food products (available only with Public Liability)

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

Employers Liability (not included in cost of Public Liability)—Please choose an option—YesNo

If yes, please state the maximum amount of employees/helpers at any one time. (cover is recommended).

10. Have you ever been convicted/ charged with a criminal offence (excluding motor)?
—Please choose an option—YesNo
If yes, please provide details.

11. 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?
—Please choose an option—YesNo
If yes, please provide details.

12. Have you suffered any claim or loss (whether insured or not) in connection with Employers, Public or Products Liability over the last 3 years?
—Please choose an option—YesNo
If yes, please provide details.

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.

Please note:
Your quotation will be sent via email to the email address supplied above, generally within an hour of receipt of your details (during business hours). Please ensure you check your email junk/spam folder in addition to your inbox for your quotation details. If you have not received any correspondence, please get in touch and we will resend.

Make sure you tick the, i/we buttons above to submit