Joint Organisation - Renewal Questionnaire

Contact Details

Registered Name of Joint Organisation*

Registered Address*

Street Address Address Line 2 City State Postcode

Contact Name*

First Last

Job Title*

Contact Email*

Contact Phone Number*

Unreported Claims

1. After reasonable enquiry by you, are there any claims or incidents/circumstances which could give rise to a claim under your existing programme which have not been reported to us?*

1a. List details of the policy, claims and cirumstances.*

Questionnaire

1. Councils within the Joint Organisation*

2. What is the total number of staff within the Joint Organisation?*

3. What is the Joint Organisations project annual revenue for the coming financial year?*

4. Does your Joint Organisation own any assets?*

4a. Please upload a declared asset schedule detailing all assets that are owned by the Joint Organisation.*

Max. file size: 600 MB.

5. Does the Joint Organisation own any motor vehicles?*

5.a Please upload a declared motor schedule detailing all motor vehicles that are owned by the Joint Organisation.*

Max. file size: 600 MB.

5b. What is the maximum vehicle accumulation value at any one location?

5c. Address of location with Maximum Accumulation Value*

6. Is the Joint Organisation’s IT systems and server separate from its member councils?*

JOINT ORGANISATION RENEWAL QUESTIONNAIRE