Once complete, please return to:

Anchorman Insurance Consultants Limited T: 01837 55777 Anchorman House, 8 Cranmere Road E: info@anchormaninsurance.co.uk Okehampton, EX20 1UE W: www.anchormaninsurance.co.uk

Anchorman Insurance Consultants Limited is authorised and regulated by the Financial Conduct Authority. Registered in England No. 3631690

Guidance Notes

JCT 21.2.1. Insurance cover (also known as Non Negligence Insurance, JCT 6.2.4 Insurance, JCT 6.5.1 Insurance and JCT 19(2)a Insurance) protects an employer against expense, liability, loss, claim or proceedings which he may sustain by reason of injury or damage to any property caused by collapse, subsidence, heave, vibration, weakening or removal of support or lowering of ground water arising out of or in the course of or by reason of the carrying out of building works undertaken on his behalf.

Insurers normally require supporting documentation to help them better understand the nature of work being undertaken and the condition of the area / surrounding property prior to work starting.

Plans, Schedules of Condition and Photographs A copy of the Building Plans, Schedules of Condition and Photographic Evidence will be required in most cases so that the Insurer can understand the type and nature of the address and the proximity to surrounding properties which is a key consideration.

Method Statement If the contract involves any form of Piling, creating of basements, work on listed buildings, façade retention or involves work undertaken near water hazards or excessively sloping sites, Insurers will require a detailed Method Statement from the Main Contractor or specialist Contractor which states the methods that are to be adopted to undertake the actual works.

Main Contractor Insurers will need the name and address of the Main Contractor who has been appointed to undertake the building work.

Contract / Project Value of Work Insurers need to know the Contract / Project Value of Work as, generally, the higher the Contract / Project Value, the higher the level of risk.

Limit of Indemnity You must arrange a limit of indemnity that is adequate to meet any claims that may be brought against you both now and in the future. When ascertaining your exposure, you must consider a realistic worst case scenario including the potential damages a claimant may pursue you for. You must also factor in their legal costs including interest payments and any consequential losses they may suffer. You should also consider the possibility of a personal injury claim being made against you.

Fair Presentation and Material Facts Before the insurance policy takes effect you have a duty to make a fair presentation of the risk to be insured under the insurance policy. A fair presentation of the risk is one:

• which: - discloses to the Insurer every material circumstance which you know of or ought to know of; or - gives the Insurer sufficient information to put the Insurer on notice that it will need to make further enquiries for the purposes of revealing those material circumstances,

• which makes that disclosure referred to above in a manner which is reasonably clear and accessible to the Insurer; and

• in which every material representation as to a matter of fact is substantially correct, and every material representation as to a matter of expectation or belief is made in good faith.

A material circumstance is one that would influence the Insurer’s decision as to whether or not to agree to insure you and, if so, the terms of that insurance. If you are in any doubt as to whether a circumstance is material you should disclose it to the Insurer. Your proposal form will form the basis of the contract between you and the Insurer, inaccuracies or misrepresentations could lead to the policy being voided, and/or a claim being refused. If you have any doubt whether information is relevant, you must declare the information in writing.

Binding into contract Completing this proposal form does not automatically bind the Insurers into contract with you, neither does it compel them to complete this insurance, you cannot assume that the contract is complete until such time you receive a written confirmation from Anchorman Insurance or the Insurers confirming cover has been granted or until such time you receive a policy schedule.

Additional Information or insufficient space If there is insufficient space to provide your answer or should you wish to provide any additional information, please use a separate piece of paper and attach this to the proposal form.

JCT Clause 21.2.1 (or equivalent) Non Negligence Insurance Proposal Form

Section 1 – Your Details Client Reference:

a) Name of Main Contractor

b) Address

Postcode

c) Name of Employer

d) Address

Postcode

e) Address of the Contract Site

Postcode

f) Please provide a general description of the Contract Site ground conditions

g) Please provide a description of the Contract and brief details of work to be undertaken. It will be helpful if specifications and plans are supplied.

h) Contract Value: £

i) Commencement date of contract:

j) Period of contract:

k) Defects Liability period:

l) Edition of contract if not JCT 1980 Edition incorporating 1986 amendments:

m) Please specify the Limit of Indemnity required:

£250,000 £500,000 £1,000,000 £2,000,000 £5,000,000 Other (please specify) £

Section 2 – The Existing Property

If the existing property is being completely demolished or the contract site has already been cleared, please proceed to Section 3. Otherwise, please answer the questions below:

a) What is the approximate age and general condition of the existing property?

b) Is the property currently occupied and, if so, for what purpose? YES NO

Occupation:

c) Will any work on the existing property require temporary propping or support? YES NO

If so, please provide details:

Section 3 – The Surrounding Property

a) Please provide the information indicated for all surrounding property (not forming part of the contract works)

Property 1

Address:

Occupation:

Condition:

Approximate Age: Approximate distance from site:

Property 2

Address:

Occupation:

Condition:

Approximate Age: Approximate distance from site:

Property 3

Address:

Occupation:

Condition:

Approximate Age: Approximate distance from site:

Property 4

Address:

Occupation:

Condition:

Approximate Age: Approximate distance from site:

b) Are you able to confirm that Schedules of Condition and/or photographic records have been prepared for each of these properties? (Assuming so, we will require sight of these.)

YES NO

If ‘NO’, please explain below why this is the case:

Section 4 – The activities involved in the Contract

a) Is anything being demolished? If “NO” proceed to b), otherwise, please provide the following information

YES NO

i) What is being demolished and the method of demolition to be adopted?

ii) If there are any internal walls or other structures, are these load bearing?

iii) Number of storeys above ground level?

iv) Distance from nearest property? (unless only internal demolition involved)

v) Is there any demolition below ground level? If so, to what maximum depth and what minimum distance from nearest property?

vi) Will shoring or propping up be required? If “YES” please provide details

b) Is any Excavation work to be undertaken? If “NO” proceed to c), otherwise, please provide the following information

YES NO

i) To what depth?

ii) Minimum distance from nearest property?

iii) Means to be adopted to support the excavation?

c) Is any Piling work to be undertaken? If “NO” proceed to d), otherwise, please provide the following information

YES NO

i) Type/method of piling?

ii) Number of piles and maximum depth?

iii) Minimum distance from nearest property?

d) Is any Underpinning work to be undertaken? If “NO” proceed to e), otherwise, please provide the following information

YES NO

i) Overall length involved?

ii) Maximum depth?

iii) Maximum length any one bay?

e) Is any Dewatering work to be undertaken? If “NO” proceed to f), otherwise, please use the box below to detail the method being used:

YES NO

e) Is any Ground Stabilisation work to be undertaken? If “NO” proceed to Section 5, otherwise, please use the box below to detail the method being used:

YES NO

i) Method?

ii) Minimum distance from nearest property?

Section 5 – Additional Information

Please use this space to provide additional information in support of the answers given within the proposal form.

Please clearly show the question number to which the information relates.

Section 6 – Important Notices

Please read the following carefully before you sign and date the Declaration and Undertaking.

IMPORTANT NOTICE CONCERNING YOUR DUTY TO MAKE A FAIR PRESENTATION OF THE RISK Before the insurance policy takes effect the Insured have a duty to make a fair presentation of the risk to be insured under the insurance policy. A fair presentation of the risk is one:

• which: - discloses to the Insurer every material circumstance which the Insured know of or out to know of; or - gives the Insurer sufficient information to put the Insurer on notice that it will need to make further enquiries for the purposes of revealing those material circumstances,

• which makes that disclosure referred to above in a manner which is reasonably clear and accessible to the Insurer; and

• in which every material representation as to a matter of fact is substantially correct, and every material representation as to a matter of expectation or belief is made in good faith.

A material circumstance is one that would influence the Insurer’s decision as to whether or not to agree to insure the Insured and, if so, the terms of that insurance. If you are in any doubt as to whether a circumstance is material you should disclose it to the Insurer.

FINANCIAL OR TRADE SANCTIONS Insurers are unable to provide insurance in circumstances where to do so would be in breach of any financial or trade sanctions imposed by the United Nations or any government, governmental or judicial body or regulatory agency.

FAIR PROCESSING NOTICE We will treat your personal information fairly and lawfully in accordance with the Data Protection Act 1998.

LIMIT OF INDEMNITY You must arrange a limit of indemnity that is adequate to meet any claims that may be brought against you both now and in the future. When ascertaining your exposure, you must consider a realistic worst case scenario including the potential damages a claimant may pursue you for. You must also factor in their legal costs including interest payments and any consequential losses they may suffer. You should also consider the possibility of a personal injury claim being made against you.

CLAIMS OCCURRING BASIS OF COVER Non Negligence Insurance is subject to a claims occurring basis of cover which means the policy covers you for claims arising during the period of insurance only.

CLAIMS NOTIFICATION Insurers require claims to be reported to them in accordance with the Claims Conditions stated within their policy. You must notify your Insurer of any circumstances that could give rise to a claim. If you are currently dealing with any matters relating to negative comments or allegations, verbal or written, relating to your professional work then you must notify your current Insurer immediately.

I/We declare that every statement and particular contained within this proposal form:

• which is a statement of fact, is substantially correct, and

• which is matter of expectation or belief, is made in good faith. Furthermore I/we understand that it is my/our obligation to provide a fair presentation of the risk to be insured and failure to do this or inaccuracies could lead to the policy being voided, and/or a claim being repudiated by the Insurer.

If any such facts, expectations and/or beliefs materially change before the insurance policy takes effect or during the period of

insurance, I/we undertake to provide details of all such changes to the Insurer in order to comply with my/our obligation to

provide a fair presentation of the risk to be insured under the insurance policy.

For the purposes of making this proposal for insurance, I/we agree that Anchorman Insurance (which I/we have appointed to

advise in relation to this policy) is acting on my/our behalf and not as an agent of the Insurer.

If this proposal has been completed in part or whole by Anchorman Insurance, I/we can confirm that I/we have checked each

and every fact, expectation and/or belief stated and declare that they are true and correct to my/our best knowledge and

belief. I/we understand that it is my/our responsibility to ensure that all facts, expectations and/or beliefs given are true and

correct and it is not the responsibility of Anchorman Insurance.

I/we understand that the limit of indemnity stated on this proposal form is the maximum payable under the policy, and I/we

am/are satisfied that this is adequate enough to cover any potential claim made against me/us. I/We understand that it is

my/our responsibility to ensure that the limit of indemnity is sufficient now and in the future.

Signature

Date

Print Name

Reference

This insurance will not commence until such time as you have received written confirmation from Anchorman Insurance Consultants Ltd that cover has been arranged. Insurers reserve the right to decline any Proposal.

JCTPROPMAR19