Semploy Extra Statement of Fact and Schedule

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1 POLICY NUMBER: L Page 1 of 7 Semploy Extra Statement of Fact and Schedule Effective Date: 27 May :00 Expires On: 26 May :00 Agent Number 23303W Date of Issue 27 May 2015 Agency Reference Reason for Issue New Business Agency Contact Name Agent Agents Telephone Number? Agents Address? Acturis User - Web Gallagher Insurance Services - Post Office New Business Premium Insurance Premium Tax 4.77 Total Premium Insured Name: Company Status Address: The Business carries out the following Trades: Year commenced in business: No. of years experience gained in Trade Jamie Nicholls LTD Limited 1 Scarlet Heights Queensbury Bradford West Yorkshire United Kingdom BD13 1BD Sports/Personal Training Please note that this Statement of Fact and Confirmation of Cover forms the basis of a legal contract between you and Ageas Insurance Limited. It is therefore essential that all the information is accurate and true to the best of your knowledge and belief. This Statement of Fact and Confirmation of Cover should be read in conjunction with the attached Policy wording. Click the following link to obtain the Policy wording Alternatively type the link into your internet browser address bar to access the document. If you require a printed version please contact your agent. Please make sure you read the Statements contained in the Statement of Fact. It may contain assumed facts. Please contact your agent immediately if any of the Statements are incorrect. Please note that you should disclose any information which may influence us in the acceptance or assessment of your insurance. If you are in any doubt as to whether information is material you should disclose it. Please contact your agent for advice. You are not required to sign this Statement of Fact and Confirmation of Cover but you should read it carefully and verify that all the information contained within it and the Policy Schedule is correct. Any incorrect information must be notified to your agent immediately. Failure to comply with any of these points may invalidate some or all of your cover. COVER DETAILS For full details of cover please refer to your Policy wording. All sections other than those noted as in the Policy Schedule apply. Post Office Business Insurance is underwritten by Ageas Insurance Limited, Ageas House, The Square, Gloucester Business Park, Brockworth, Gloucester GL3 4FA. Registered Office Address: Ageas House, Hampshire Corporate Park, Templars Way, Eastleigh, Hampshire SO53 3YA. Registered in England and Wales. No Ageas Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority Post Office Business Insurance is administered by Gallagher Heath Insurance Services which is authorised and regulated by the Financial Conduct Authority. Gallagher Heath Insurance Services is a trading name of Heath Lambert Limited. Heath Lambert Limited is authorised and regulated by the Financial Conduct Authority. Registered Office: The Walbrook Building, 25 Walbrook, London EC4N 8AW. Registered in England and Wales. No Post Office Ltd is registered in England and Wales. No Registered Office: Finsbury Dials, 20 Finsbury Street, London. EC2Y 9AQ. Post Office is a registered trade mark and the Post Office logo is a trade mark of Post Office Limited.

2 POLICY NUMBER: L Page 2 of 7 SEMPLOY EXTRA Proposal Declaration - Answers provided by your agent on your behalf It is a statement of fact that: No Proposer, Director or Partner of the Trade or Business or its Subsidiary Companies, either personally or in any business capacity has ever: been declared bankrupt or insolvent or been the subject of bankruptcy proceedings or insolvency proceedings had a proposal refused or declined or ever had an insurance cancelled, renewal refused or had special terms imposed had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or has any prosecutions pending Losses or incidents giving rise to losses in the last 5 years: None Details of activity carried out by the Insured The maximum depth (below ground) to which work is undertaken (in metres) The maximum height at which work is carried out (in metres) Not Applicable Not Applicable 3 Phase electrical work is undertaken No Gas fitting or installation work is undertaken The Business does not use Flame Cutting Equipment, or any Welding Plant or Equipment No-one employed by, or who is an apprentice, trainee or who is on work experience for the business, operates fixed wood working machinery. Details of Persons working in the business: Directors 1 Partners/Principals/Proprietors 0 Permanent Staff 0 Temporary Staff 0 Labour Only Subcontractors 0 Bona Fide Sub-Contractor 0 Number of Clerical Workers 0 No

3 schedule section starts here POLICY NUMBER: L Page 3 of 7 New Business SECTION 1 LIABILITY SEMPLOY EXTRA POLICY SCHEDULE POLICY SECTIONS Sub-Section A - Public Liability Limit of Indemnity 5,000,000 Number of People Insured for manual/non-manual work 1 In addition up to 6 People are automatically insured for clerical work in respect of Sub-Section A - Public Liability. Standard excesses that apply: Third Party Property damage Excess 100 If an Insured has less than two years experience in the trade, any excess is increased by a further 250 Sub-Section B - Employers Liability SECTION 2 TOOLS AND STOCK IN TRANSIT SECTION 3 CONTRACTORS ALL RISKS SECTION 4 LEGAL EXPENSES SECTION 5 PERSONAL ACCIDENT GROUP (24 HOURS) Not Insured Summary of Endorsements Applying to the Policy The following endorsements are applicable to this Policy: Endorsements Applicable to the whole Policy: None Endorsements Applicable to Individual Trades: Trade Description Sports/Personal Training Endorsement Number SE58 SE58 Fitness Advice - Exclusion to Section 1 - Liability The Companyshall not indemnify the Insured in respect of any claim arising from or in connection with the provision of advice or recommendation relating to the physical ability, health or fitness of any person(s). Post Office Business Insurance is underwritten by Ageas Insurance Limited, Ageas House, The Square, Gloucester Business Park, Brockworth, Gloucester GL3 4FA. Registered Office Address: Ageas House, Hampshire Corporate Park, Templars Way, Eastleigh, Hampshire SO53 3YA. Registered in England and Wales. No Ageas Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority Post Office Business Insurance is administered by Gallagher Heath Insurance Services which is authorised and regulated by the Financial Conduct Authority. Gallagher Heath Insurance Services is a trading name of Heath Lambert Limited. Heath Lambert Limited is authorised and regulated by the Financial Conduct Authority. Registered Office: The Walbrook Building, 25 Walbrook, London EC4N 8AW. Registered in England and Wales. No Post Office Ltd is registered in England and Wales. No Registered Office: Finsbury Dials, 20 Finsbury Street, London. EC2Y 9AQ. Post Office is a registered trade mark and the Post Office logo is a trade mark of Post Office Limited.

4 POLICY NUMBER: L Page 4 of 7 CLAIM NOTIFICATION You can contact Ageas Claims Department on The line is open 24 hours a day, 365 days a year. The claims handler will ask you your name, policy number and full details of the loss circumstances. You will be advised on the procedures and what documentation is required by us to deal with your claim. Alternatively you can fax details on or write to Commercial Claims, Ageas Insurance Limited, Ageas House, The Square, Gloucester Business Park, Brockworth, Gloucester GL3 4FA, England. For claims under Section 4 Legal Expenses, please contact the Claims Helpline on The line is open from 9.00am to 5.00pm Monday to Friday. The claims handler will take your details and send you a claim form to be completed and returned. Full claims procedures are noted in our Policy wordings. LEGAL & BUSINESS HELPLINE SERVICES As an Ageas policyholder with a current Policy you are automatically entitled to use the following helpline services. All helplines apply to the UK unless otherwise stated. To help us to check and improve our service standards calls are recorded. BUSINESS LEGAL ADVICE This helpline is available 24/7, 365 days a year to provide confidential legal advice over the phone on legal problems affecting your business, under the laws of the member countries of the European Union, the Isle of Man, the Channel Islands, Switzerland and Norway. UK TAX ADVICE This helpline is available between 9.00am and 5.00pm from Monday to Friday to provide confidential advice over the phone on any tax matters affecting your business, under the laws of the United Kingdom. BUSINESS EMERGENCY ASSISTANCE This helpline is available 24/7, 365 days a year to arrange help straight away if an unforeseen emergency causes damage to your business premises or creates a health and safety hazard. We will contact a suitable repairer or contractor and arrange assistance on your behalf. All costs of assistance provided are your responsibility. CONFIDENTIAL COUNSELLING HELPLINE This helpline is available 24/7, 365 days a year offering confidential support if an employee needs help to cope with a source of upset, stress or anxiety. Due to their sensitivity counselling calls are not recorded. Please do not phone the helpline service numbers to report a general insurance claim. We will not accept responsibility if the helpline services fail for reasons beyond our control.

5 Health and safety for small/medium sized businesses How my insurer helps me manage my health and safety risk Good health and safety standards help you to run your business successfully. Meeting the requirements of relevant regulation is a central factor in achieving this. Insurers recognise the wider benefits to society of encouraging businesses in following sensible, proportionate measures aimed at helping them to carry out their activities. We are providing this information to help you take sensible steps to manage health and safety effectively. Insurers will continue to settle legitimate claims. Insurers will also co-operate with businesses such as yours if you need to deal with the consequences of vexatious claims made against you. Your insurer will always be willing to offer you guidance on what constitutes good practice in managing health and safety. This guidance should be aimed at improving the resilience of your business in dealing with civil law claims made against you, and will be proportionate to the level of risk involved. Employers liability vs public liability what s the difference? Insurers provide cover for businesses legal liabilities by issuing: Employers liability policies this covers employers for injury or disease to people they employ; and Public liability policies this covers businesses for injury, disease or damage to people they do not employ, for example visitors. The law - the Health and Safety at Work etc. Act 1974 This is the main law on health and safety and says that every employer is to ensure, so far as is reasonably practicable, the health and safety of employees and also persons not in their employment who may be affected by work activities. Your insurer expects you to take reasonable steps to comply with this requirement and other related regulations, using the guidance and tools provided by the Health and Safety Executive (or other competent organisations) to help with this aim. You can find more information at Your insurer will not refuse to pay a claim purely because of a breach of health and safety regulations. Your insurer will not withdraw cover mid-term purely because of a breach of health and safety regulations. This document has been created as generic guidance for small and medium sized businesses and does not constitute legal advice. If you have any questions relating to health and safety management that this document does not address, you should discuss them with your broker or insurer. Page 1

6 Who is an employee? There are various forms of employment. Often a working individual may not be engaged under a contract of employment. For this reason, insurers include, under an employers liability policy, a definition of who is to be treated as an employee. A typical definition would be: Any person employed under a contract of service or apprenticeship; people on work experience schemes, for example, students; any person hired or borrowed from another employer including drivers or operators of hired in plant; labour only subcontractors; and home workers. All these people are covered while working for and under your control in your business. Some common concerns Documentation Insurers do not generally need you to show any formal evidence that you are keeping to health and safety regulations nor do they ask to see health and safety documents as a condition of granting insurance cover. Written risk assessments The role of health and safety consultants However, although it is not a legal or insurance requirement to do so, good record keeping (for example, training records, written risk assessments etc.) may be useful if you need to defend a civil law claim. If you employ fewer than five employees, there is no need for you to complete written risk assessments. However, although completing and recording risk assessments is not a legal or insurance requirement, it may help in defending any civil law claims made against you. You do not need to hire a health and safety consultant. The law says that you must have access to competent health and safety advice often, this is available from your own staff. If, however, the complexity or nature of your business indicates that you do need external support, your insurer will normally recommend that you use a health and safety consultant who is listed on the Occupational Safety and Health Consultants Register. You can get more information at This document has been created as generic guidance for small and medium sized businesses and does not constitute legal advice. If you have any questions relating to health and safety management that this document does not address, you should discuss them with your broker or insurer. Page 2

7 Testing portable electrical appliances There is no specific legal requirement for every portable electrical appliance to be tested each year and your insurer will not insist upon this when offering you insurance. However, as you must maintain this equipment suitably to prevent danger, insurers recommend you follow the guidance published by the HSE, available at For specific guidance, read Maintaining portable electric equipment in low risk environments, available at More help Insurers approve the principles set out in the Association of British Insurers Key Principles document: Health and Safety for Businesses and the Voluntary Sector. This is available at You can also find more guidance on the HSE website available at This document has been created as generic guidance for small and medium sized businesses and does not constitute legal advice. If you have any questions relating to health and safety management that this document does not address, you should discuss them with your broker or insurer. Page 3

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