Trading Details 1. Please provide full details of business, goods sold/ services and/or activities:
Please provide your projected turnover per annum. —Please choose an option— Less than €10,000.00 Less than €20,000.00 Less than €50,000.00 More than €50,000.00 please advise other other
2. Do you hold, or have you previously held, Public Liability? —Please choose an option— Yes No
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— Manufacture, sale, supply and delivery of your goods to other 3rd parties only Sale, supply and delivery of your goods to other 3rd parties only Sale, supply, delivery and/or collection (from premises) of your goods to other 3rd parties Sale of your goods online and to other 3rd parties for resale Sale of your goods online only Other
If other, please advise.
4. Locations in which your product will be sold. If also attending a market/event, please provide name(s) of market/event(s) attended.
5. Do you require any additional cover. 1. —Please choose an option— No Additional cover Attending Markets/Events/Street trading Classes (please describe class activities below) Prep Kitchen (please provide prep kitchen address below) Online sales Fixed premises (shop, pop-up shop, home etc.. please provide the size of the shop/unit below) Polytunnels/garden area Demonstrations/ in-store sampling Other (please provide details below) 2. —Please choose an option— No Additional cover Attending Markets/Events/Street trading Classes (please describe class activities below) Prep Kitchen (please provide prep kitchen address below) Online sales Fixed premises (shop, pop-up shop, home etc.. please provide the size of the shop/unit below) Polytunnels/garden area Demonstrations/ in-store sampling Other (please provide details below) 3. —Please choose an option— No Additional cover Attending Markets/Events/Street trading Classes (please describe class activities below) Prep Kitchen (please provide prep kitchen address below) Online sales Fixed premises (shop, pop-up shop, home etc.. please provide the size of the shop/unit below) Polytunnels/garden area Demonstrations/ in-store sampling Other (please provide details below) 4. —Please choose an option— No Additional cover Attending Markets/Events/Street trading Classes (please describe class activities below) Prep Kitchen (please provide prep kitchen address below) Online sales Fixed premises (shop, pop-up shop, home etc.. please provide the size of the shop/unit below) Polytunnels/garden area Demonstrations/ in-store sampling Other (please provide details below) Details.
5b. Will you be cooking or heating food, drinks or services involving heat at any market or event. —Please choose an option— Yes No If yes, Please give details of equipment used.
8. 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— Yes No
Products Liability – food and drink products only —Please choose an option— Yes No
Non-food Product Liability – 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— Yes No
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— Yes No
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— Yes No
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— Yes No
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.
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