Entertainment & Events Liability Entertainment & Events Liability This policy is only available to Australian domiciled persons. Where did you hear about Action Entertainment Insurance? * Have you previously spoken to an Action Representative regarding this quote? Yes No Name of representative? Name of Insured * ABN Are you completing this proposal as a client or broker on behalf of the client? * Client Broker Brokerage Name * Contact Name * Postal Address * Suburb * State * Please selectACTNSWNTQLDSATASVICWA Postcode * Phone Number * Fax Number Email Address * Website Address Client's Address * Clients Website Address Business activities to be insured * Please describe your activities in as much details as possible Please select those that best describe your activities * Entertainer/Performer/Musician/Band etc. Theatre/Performance Group Drama/Dance School Booking Agent Event Organiser/Concert Promoter Event Manager / Event Coordinator Market Organiser Film & Video Production Community Group/Non-profit Organization Public Address, Lighting, Audio Visual, Staging or Rigging How many years experience do you have in this field and/or how long has your business been operating for? Please select123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960 Period that cover is required for * Annual Short Term From Time * Please select0:00:00 (midnight)0:15:000:30:000:45:001:00:001:15:001:30:001:45:002:00:002:15:002:30:002:45:003:00:003:15:003:30:003:45:004:00:004:15:004:30:004:45:005:00:005:15:005:30:005:45:006:00:006:15:006:30:006:45:007:00:007:15:007:30:007:45:008:00:008:15:008:30:008:45:009:00:009:15:009:30:009:45:0010:00:0010:15:0010:30:0010:45:0011:00:0011:15:0011:30:0011:45:0012:00:0012:15:0012:30:0012:45:0013:00:0013:15:0013:30:0013:45:0014:00:0014:15:0014:30:0014:45:0015:00:0015:15:0015:30:0015:45:0016:00:0016:15:0016:30:0016:45:0017:00:0017:15:0017:30:0017:45:0018:00:0018:15:0018:30:0018:45:0019:00:0019:15:0019:30:0019:45:0020:00:0020:15:0020:30:0020:45:0021:00:0021:15:0021:30:0021:45:0022:00:0022:15:0022:30:0022:45:0023:00:0023:15:0023:30:0023:45:00 To Time * Please select0:00:00 (midnight) Limit of cover required * Please select$5,000,000$10,000,000$20,000,000 Please provide address or location of where you will be predominantly carrying out your business activities Location of risk * If cover only required for short term period or one-off event, please provide estimated turnover for short-term period/one off event Please advise the estimated turnover of your business for the next 12 months? * If cover only required for short term period or one-off event, please provide estimated wages for short-term period/one off event. Please advise the estimated wages of your business for the next 12 months? Do you require cover for any activities outside of Australia? * Yes No Working Abroad Details Which countries will you be working in? Dates of travel / time spent in each country? Details of activities conducted overseas? Turnover derived from overseas activities? Number of Employees If you are a non-profit organisation, total number of members Do you use contractors / sub-contractors? * Yes No What activities will your contractors carry out Estimated payments to contractors / sub-contractors Do you insist on your contractors / sub-contractors carrying their own public liability insurance? Yes No This will be a condition of cover Will you be signing any contracts that contain hold harmless or indemnity agreements? * Yes No Note: a hold harmless or indemnity agreement is whereby one party assumes the liability risks of another party under contract. Your public liability policy is to cover your legal liability and no one else’s, therefore claims arising from these agreements is excluded. Please do not sign these agreements. If you do without first referring them to your insurer, you may not be covered in the event of a claim. 1. GENERAL INFORMATION – PLEASE COMPLETE THIS SECTION FOR ALL OCCUPATIONS Will you be signing any contracts that contain hold harmless or indemnity agreements? * Yes No Please provide copies of such agreements Drop a file here or click to upload Choose File Maximum file size: 2.1MB Note – a hold harmless or indemnity agreement is whereby one party assumes the liability risks of another party under contract. Your public liability policy is to cover your legal liability & no one else’s, therefore claims arising from these agreements are excluded. In some circumstances, your policy can be amended to include cover for these agreements providing your Insurer can review them & agree to their content. If you sign these agreements without first referring them to your Insurer, you may not be covered in the event of a claim. Will you require cover for liability claims arising from loss or damage to other people’s property whilst in your care, custody or control? * Yes No Please advise limit of cover required? Note – the above extension only operates if you are negligent in causing the loss or damage to the property in your care, custody or control. There can be situations where you have hired or borrowed other people’s property, & such property is lost or damaged not as a result of your negligence. However, you may still be responsible for compensating the owner for their loss. In these circumstances, it would be prudent not to rely on the above extension on its own but also insure the hired or borrowed property under a General property insurance policy, which will operate regardless of fault or negligence. Have you suffered any public liability claims or have caused incidents that could give rise to a public liability claim? * Yes No Please provide details Have you previously been insured for liability? * Yes No Please advise name of Insurer In the last 10 years, have you ever had any criminal convictions, been bankrupt or refused insurance? * Yes No Please provide details Will your activities include the use of any of the following: Registered motor vehicles Yes No Watercraft Yes No Aircraft or hovercraft Yes No Are you running Workshops, Dance Classes, Drama Classes or Teaching Other Activities? * Yes No Please describe what is being taught? * Total Number of Students or Participants * How many classes per Annum? Number of students per class? * How many workshops per Annum? Number of participants per workshop? How many teachers / trainers / supervisors? * What is the experience / qualification of the trainers / teachers? Do students participate in hazardous, strenuous or physical activities? * Yes No Please describe nature of activities Do your classes or workshops include any Aerial or Trapeze circus activities? * Yes No Do all students/participants (or their parents/guardians) sign waivers? Yes No Please provide copy Drop a file here or click to upload Choose File Maximum file size: 2.1MB Age of students/participants? Please advise safety in place in respect to Aerial & Trapeze activities? Please attach risk management plan & safety procedures Drop a file here or click to upload Choose File Maximum file size: 2.1MB In addition to the classes or workshops, will you stage any concerts, performances or events? * Yes No If yes, please advise number of concerts/performances/events for next 12 month period, including average attendance per event: Number of events Attendance per event Are you a Performer, Musician, Entertainer, Band etc? * Yes No What style is your performance? * Please selectEntertainer/Performer/Musician/Band etc.Theatre/Performance GroupDrama/Dance SchoolBooking AgentEvent Organiser/Concert PromoterEvent Manager / Event CoordinatorMarket OrganiserFilm & Video ProductionCommunity Group/Non-profit OrganizationPublic Address, Lighting, Audio Visual, Staging or Rigging Number of musicians / performers / operators / entertainers etc? * Are you booked through an agent or by the venue or event organizer to turn up and perform (including “door-deals”)? * Yes No Will you ever hire a venue to put on your own performance (i.e. self-promote)? Yes No If yes, please complete Section “Are You Staging An Event or Concert” Please advise estimated number of performances during annual period Estimated attendance at each performance Please provide average attendance per event if insuring more than one event Please give examples of the types of venues you will perform in? Are you contracted as an Event Manager / Coordinator? * Yes No Please advise the types of event you are involved in? * Number of events you are involved in? * Estimated attendance at each of the events? * Please define your role, responsibilities and duties? * Who is responsible for hiring the venues? * Will the Event Owner/Promoter/Principal arrange their own Public Liability insurance for the events? * Yes No Will you be serving, selling or supplying alcoholic beverages at your event? * Yes No Who is actually selling or serving the beverages? * Do they carry their own liability insurance for this activity? Yes No Who has signed the liquor license? Please advise how many bar staff will be engaged? Estimated number of bar staff per event? Are all staff RSA qualified (or equivalent)? Yes No Is the alcohol being served in a restricted area? Yes No Will the security be responsible for monitoring & overseeing this area? Yes No What experience does the Insured have in the responsible service of alcohol? Do you have a service of alcohol procedure in place? Yes No If yes, please attach copies Drop a file here or click to upload Choose File Maximum file size: 2.1MB Are you staging an Event (including Multiple Events, Concerts, Festivals, Markets, Cultural Events, Community Events, Fundraisers and including Performers / Bands who self promote etc), an Event Promoter or an Event Principal? * Yes No Do you require annual cover for all events staged during annual period? * Yes No Number of events, concerts or performances to be covered? * Estimated attendance at your event / events? (Please provide average attendance per event if insuring more than one event) * Please describe nature of your event / events? * Please advise if your event will involve any of the following activities? Live Music / Theatrical / Dance / Artistic Performance Yes No Will any members of the public or audience members participate in any sporting, adventure, or dangerous activities? Yes No Please describe the activies they will participate in * Please attach copy of waiver Drop a file here or click to upload Choose File Maximum file size: 2.1MB Swimming activies or water sports Yes No Will camping facilities be available to patrons Yes No Estimated number of campers? What facilities will be provided for campers? Competitive Motor sport activities Yes No Static Vehicle Displays Yes No How many vehicles on display Food / Market Stalls or Exhibitors? Yes No Please advise number of stall holders / exhibitors Will all stall holders / exhibitors carry their own liability insurance? Yes No It is recommended that you insist on all stall holders or exhibitors carry their own Public & Products Liability insurance Amusement Rides, Devices or Animal Rides? Yes No Please ensure that all amusement / animal ride contractors carry their own public liability insurance For amusement rides/devices, will owners/operators of same remain in attendance with their ride/device during the duration of your event? * Yes No Will you ensure that all owners/operators of Amusement rides/ devices/animal rides have their own Public Liability Insurance in place? Yes No Fireworks or pyrotechnic displays Yes No Please advise name of fireworks operator? Use of watercraft in your event Yes No Use of aircraft in your event Yes No Car parking facilities Yes No Please advise number of vehicles Car parking charge per vehicle Are you directly responsible for car parking facilities? Yes No Is your event a Dance Party? * Yes No Please confirm the age range of attendees Date of Event * Location where event is to be held If you are running multiple events, please provide an Event Schedule. Drop a file here or click to upload Choose File Maximum file size: 2.1MB Is the event being held indoors or outdoors * Indoor Outdoor Is your event an outdoor Music Festival or Concert? * Yes No Please provide layout plan for each venue Drop a file here or click to upload Choose File Maximum file size: 2.1MB Are there any water courses within the Event site/s such as dams, rivers, canals, water holes etc? * Yes No Have pre checks of the venue been conducted in respect to possible hazards? i.e. pot holes? What first aid facilities have been arranged? Who is responsible for security bag checks prior to entry to the events? What items are prohibited by the promoted as not being allowed in? What activities are prohibited by the promoter? i.e. ball sports etc Who is responsible for stage set up? Is there any temporary seating structures being used? Yes No If yes, please ensure that the contractor responsible for supplying and setting up these structures carries their own public liability insurance. Name of event Event Times From Time 121234567891011 : 00153045 AMPM To Time 121234567891011 : 00153045 AMPM Artists performing (if applicable) If your event is a concert or performance, what style of music or performance is being performed? Estimated ticket price (if applicable) Do you have a risk management plan or safety procedures for your event/events? * Yes No Upload risk management plan or safety procedures file Drop a file here or click to upload Choose File Maximum file size: 2.1MB Will you have security at your event? * Yes No Who will be responsible for security? Please ensure that the contracted security company carries their own public liability insurance Please advise number of security personnel to patrons? Will you be serving, selling or supplying alcoholic beverages at your event? * Yes No Who is actually selling or serving the beverages? * Do they carry their own liability insurance for this activity? Yes No Who has signed the liquor license? Please advise how many bar staff will be engaged? Are all staff RSA qualified (or equivalent)? Yes No Is the alcohol being served in a restricted area? Yes No Will the security be responsible for monitoring & overseeing this area? Yes No What experience does the Insured have in the responsible service of alcohol? Do you have a service of alcohol procedure in place? Yes No If yes, please attach copies Drop a file here or click to upload Choose File Maximum file size: 2.1MB Are you carrying out any Film & Video Production activities? * Yes No Are you the overall producer of the Production/s? Yes No What type of productions will you be filming? * Feature Films Documentaries TV Productions Corporate Videos Private & Public events or occasions TV Commercials Music Video Clips Short Films Other Estimated number of productions during the period of insurance? * Estimated number of filming days during the period of insurance? * Estimated production budget? Will your productions involve the use of: Will there be large crowds involved in the production(s)? Yes No Please provide details: Fire, Fireworks, Pyrotechnics? Yes No Please provide details: Stunts or explosions? Yes No Please provide details: Dangerous Activities? Yes No Please provide details: Aircraft, watercraft or motor vehicles? Yes No Please provide details: Where will the majority of the filming take place? In Studio On Location Please provide a Synopsis of your Film/s Upload Synopsis of your Film/s Drop a file here or click to upload Choose File Maximum file size: 2.1MB Please provide location where filming is to take place? * Please provide the percentage of work on location & details % * Disclaimer Privacy Policy At Action Entertainment Insurance Pty Ltd Corporate Representative No. 237473 as an authorised representative of Action Insurance Brokers P/L AFS 225047, we are committed to protecting your privacy in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles. This Privacy Policy describes our current policies and practices in relation to the collection, handling, use and disclosure of personal information. It also deals with how you can complain about a breach of the privacy laws and how you can access the personal information we hold and how to have that information corrected. Please visit https://www.entertainmentinsurance.net.au/privacy-policy to read our full privacy policy. Your Duty of Disclosure When entering into a contract of general insurance you need to tell us Before you enter into a contract of general insurance with us, you have a duty, under the Insurance Contracts Act 1984, to disclose to us every matter that you know, or could reasonably be expected to know, is relevant to our decision whether to accept the risk of the insurance and, if so, on what terms. When entering into a subsequent or renewing a contract of general insurance You have the same duty to disclose any matter to us before you renew, extend, vary or reinstate a contract of general insurance, which may affect our decision to insure you. What you are not required to disclose Your duty does not require disclosure of any matter: 1.That diminishes the risk to be undertaken by us; 2.That is of common knowledge; 3.That we know or, in the ordinary course of our business, ought to know; 4.Where compliance with this duty is waived by us. Non disclosure and its consequences If you fail to comply with your duty of disclosure at law, and/or have not answered our questions honestly and not told us what you, as a reasonable person in the circumstances would have answered, we may be entitled to reduce our liability under the contract in respect of a claim or may cancel the contract. Fraudulent non disclosure and its consequences If your non disclosure is fraudulent, we may also have the option of avoiding the contract from its beginning. Subrogation You may prejudice your rights with regard to a claim if, without prior agreement from the Insurer, you make agreement with a third party that will prevent the Insurer from recovering the loss from that, or another party. Your policy contains provisions that either exclude the Insurer from liability or reduce their liability, if you have entered into any agreements that excludes your rights to recover damages from another party in relation to any loss, damage or destruction which would allow you to sustain a claim under this policy. * I have read and understand the Statutory Notices * I have read and understand the Subrogation Clause Submit If you are human, leave this field blank.
