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Brady Insurance
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PROPOSER DETAILS:  
Name:  
Address:  
Phone No :  
Email:  
Insurer :  
Please advise your Renewal Date :  
Type of Insurance Required :  
Please provide details of the cover you require:  
Business Description / Occupation :  
Years Trading :  
Details of Any Claims in last 5 years :  
Public Liability Limit of Indemnity:  
Projected Annual Turnover :  
Do you have employees :  
Do you have any sub-contractors:  
Please provide any other relevant information here :  
Buildings:  
Contents :  
Stock :  
Other Covers Required? :  
Details of Security (Alarm, Locks etc) :  
Details of Property (age, Construction, heating, Flat roof)  
Details of Fire Protections (Smoke Alarm, extinguishers, Linked Fire Alarm etc)  
Is property in good state of repair?  
Is property within 250m of water course?  
Provide details of other tenants?  
Event:  
Please provide details of your Event:  
Event Date : From:  
To:  
What Safety Proecedures are in place:  
What supervision is in place:  
What experience have you of running similar events:  
   
 
 
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Insurance House, Main Street, Carrick on Shannon, Co. Leitrim. P: 071 962 0193 F: 071 962 0411
E:
Joseph G Brady Insurance Ltd, trading as Brady Insurance is regulated by the Central Bank of Ireland