FORM FOR MARKET OPERATORS

While we cannot provide cover over the internet we are expert in arrangeing cover for market operators and we are happy to provide a quote for cover.

Complete the form below and submit it to us and we will get in touch with you to see what can be arranged.

Contact name:


Contact phone number:


Contact email address:


Full name of markets (including entity name and trading names if applicable):


Location(s) where the markets are held:


Frequency of markets (ie weekly, monthly, etc):


How long has/have the market(s) been established:


What is the gross annual turnover of the market operations (ie gross revenue before expenses):


Do the markets include any of the following:
  • Jumping castles
  • Amusement rides
  • Onsite entertainment
  • Sale of alchohol
Yes
No
If yes, please describe them:


What limit of indemnity is required:
$10 Million
$20 Million

Are you currently insured?:
Yes
No
If yes, please advise expiry date and name of current insurer:


Have you had any previous claims?:
Yes
No
If yes, please advise full details:

Do you have a documented risk management plan in place?*
Yes
No

Are all stallholders required sign a stallholders agreement that outlines the terms and conditions of leasing a stall at your market?*
Yes
No

Do you have a diagram of the market that provides a layout of all stalls?*
Yes
No

(* Please note - a copy of these documents will be required to be provided prior to cover being placed should our quotation be accepted.)

Average number of members of the public who attend each market day:


Average number of stallholders per market day:


Are stallholders required to hold their own liability insurance?:
Yes
No

What checks are made to ensure that stallholders have valid public and/or product liability insurance?:


For an additional cost, cover can be included for a limited number of uninsured stallholders. Would you like this cover?:
Yes
No

If yes, please advise approximate number of uninsured stallholders that may require cover per market day:


Do you engage contractors/sub contractors to provide any services (ie rides, entertainment etc)?:
Yes
No

Do you require all contractors to maintain their own Liability Insurance?:
Yes
No

Do you have any special requirements in regards to your liability insurance (e.g. noting the interests of local councils or others)?:
Yes
No
If yes, please advise full details:


Have you or any person associated with this activity ever:
a) Had a legal liability claim made upon you or any other person? Yes No
b) Ever made a claim for insurance in respect of the type of cover required? Yes No
c) Been refused insurance? Yes No
d) Had an insurance claim of any type refused or reduced? Yes No
e) Been refused insurance? Yes No
f) Been charged with a crime of any type? Yes No

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Copyright © 2008 www.netinsure.com.au. All rights reserved. Netinsure is a registered business name of Chegwyn Insurance Brokers Pty Ltd (AFLS 283020) ABN – 79 110 736 877 This Insurance is provided wholly by SRS Underwriting Agency Pty Ltd who are acting under an authority given to them by various syndicates at Lloyds of London. Chegwyn Insurance Brokers & netinsure are in no way acting as an Agent of the Insurer in regards to the issue of the policy. The decision to accept or decline cover is at the sole discretion of SRS Underwriting Agency Pty Ltd in their capacity as Agents of the Insurer