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© 2025 Prestige Insurance Brokers (UK) Limited

Fact find questionnaire

CHARITIES, COMMUNITY GROUPS &
OTHER NOT-FOR-PROFIT ORGANISATIONS

FILL OUT THE FORM BELOW TO GET AN INSURANCE QUOTE

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Contact name

Phone

Email

Insurance renewal date

Current insurer

Premium

Organisation name:

Staus of entity

Year established (YYYY)

Address of registered or principal office

Can you confirm that your organisation is charity or non-for-profit organisation?

Yes
No

Can you confirm that your activities are designed for the benefit of your service users and are NOT primarily to promote a political or religious beliefs?

Yes
No

Address of the premises where you usually provide service

Does the organisation own these premises, or are you responsible for insuring the buildings?

Yes
No

Name of ownership on title deeds?

Date of purchase

If applicable

How many directors and/or partners the organisation have in total?

1
2
3
4 or more

1) Full name / Date of Birth / Position held

2) Full name / Date of Birth / Position held

3) Full name / Date of Birth / Position held

4) Full name / Date of Birth / Position held

Other directors and/or partners and/or officers Full name / Date of Birth / Position held

Has any proposer, director, or partner ever:

had a proposal refused or declined
had an insurance cancelled
had a renewal refused
had special terms imposed
None

Does the organisation had any mergers or amalgamations with another Association or Charity in last 5 years?

Yes
No

Details of mergers or amalgamations:

Provide a statement, which best describes your Charity/Association

Any certification, examination, licensing or regulatory activities or functions undertaken?

Yes
No

Details of certification, examination, licensing or regulatory activities or functions undertaken

Please provide details

Do you have any outstanding issues with any regulatory authority which might impact your ability to continue to operate or do you anticipate any such issues will arise within the proposed period of insurance?

Yes
No

Are you aware of any unresolved or pending objections to any applications, renewal or registration?

Yes
No

Are you aware of any complaints lodged with the regulatory authority in respect of your activities?

Yes
No

Are the funds managed by suitably qualified external professional managers?

Yes
No

Details of current fund managers, period in management and experience in fulfilling this function:

Any changes of external fund managers during the last three years?

Yes
No

Details of changes:

Full legal rights maintained against external fund managers

Yes
No

Details of legal agreement:

Any complaints made to the Charity Commissioners or other regulatory or official body or institution?

Yes
No

Details of complaints:

Any investigation by the Charity Commissioners or other regulatory or official body or institution?

Yes
No

Details of investigation:

Which of the following groups the best describes your activities:

Counselling, advocacy, outreach, rehabilitation, well being, support group
General community or neighbourhood groups, social groups, hobby or local interest groups, pure fundraising
Nurseries, playgroups or after school clubs
Provision, management and administration or facilities for the benefit of the community
Training, education
Youth and children's group, clubs, societies
Other

Please tick all that apply

Please provide details:

Are you registered by OFSTED?

Yes
No

Please provide details:

Are you a school?

Yes
No

Do you organise any fundraising events?

Yes, we organise events where the attendance is NOT expected to exceed 500 people
Yes, we organise events where the attendance is expected to exceed 500 people
No, we do not organise any fundraising events

We refer to: Parties, competitions, bazaars, charity auctions, coffee mornings, collections, conferences, craft fairs, dances, exhibitions, displays, shows, fun runs and walks, jumble sales, concerts etc.

Do you undertake any of the following activities:

Archery
Ballooning
Clay-pigeon shooting
Dry slope skiing
Gliding
Mountaineering, cliff or rock climbing (including indoor climbing)
Parachuting
Pot-holing or any subterranean activities
Sailing or canoeing
Swimming or diving
Adventure activities undertaken at activity centres registered with and licensed by the Adventure Activities Licensing Authority

Are any of your service users or volunteers are children under 18 years old?

Yes
No

Can you confirm that you:

have a Child Protection Policy that is renewed and kept up to date
have procedures in place to prevent "one to one" situations"
have signing-in /signing-out procedures in place
give consideration to the segregation of age ranges when providing your service
ensure that all staff and volunteers working with or might come into contact with children undergo DBS checks at "Enhanced" level

Are any of your service users are vulnerable adults?

Yes
No

Do you provide service in the service user's home?

Yes
No

Can you confirm that all staff and volunteers providing service in the home of the service user undergo DBS checks at "Enhanced" level?

Yes
No

Do you have any paid employees?

Yes
No

Employer PAYE No

Total number of employees?

Employees details: Name/ Role/ Qualification/ Year qualification obtain (YYYY)/ Length of time in this role/ Years of experience.

Details of training and supervision:

Estimated Wageroll (next twelve months) (£)

Are all employees paid below PAYE threshold?

Yes
No

(inc. LOSC, trainees, apprentices)

Estimated Turnover for the next twelve months

Turnover persentage split:

Percentage of turnover to be derived from sale of goods?

Percentage of turnover from sale of second hand goods?

Percentage of turnover derived from providing personal care service?

Please provide details including the number of staff trained/qualified for each type of service/ treatment.

Percentage of turnover derived from activities and functions?

Please provide details of the service provided

Percentage of turnover derived from medical/surgical care, treatments or advice?

Please provide details of the service provided

Percentage of turnover derived from scientific/medical research?

Please provide details of the service provided

Percentage from legal/financial/environmental advice?

Please provide details

Percentage of turnover derived from specific charge/fee?

Please provide details of the service provided

Percentage of turnover derived from contract/services?

Please provide details of the service provided

Can you confirm that:

there have been no fundamental changes to your activities during the past 3 years
all staff and volunteers are suitably qualified, experienced and trained in respect of the services provided
you maintain an up-to-date accident and incident book
you are able to meet you financial obligations as they fall due

Gross fees for last complete financial year

Voluntary income and donations

Income from subscriptions or membership fees

Income from fee generating activities

Income from other sources

Please provide details

Income from funding by Government, Local Authorities

CURRENT YEAR

Total estimated fees for current financial year (£)

Percentage from UK/EU (%)

Percentage from USA (%)

PREVIOUS YEAR

Total fees for previous financial year (£)

Percentage from UK/EU (%)

Percentage from USA (%)

Business hours:

Is the building listed?

Yes
No

Year the property was built?

Provide details of the listing

Number of stories where floor is of concrete construction

Number of storeys where floor is of wooden construction

What materials are the property walls made of?

Please provide percentage split, if the walls are made of more than one material

What materials is the property roof made of?

Please provide percentage split, if the roof is made of more than one material

Is there an area of roofing flat?

Yes
No

If yes, please state the approximate percentage of the roof being flat?

Heating & fuel type

Are the premises securely locked and protected when not in use or unattended?

Yes
No

Are the premises in a good state of repair and free from damage?

Yes
No

Is there any large tree within 3,5 meters?

Yes
No

Has the property ever suffered from flooding?

Yes
No

Is an ATM located on the premises?

Yes
No

Please select all risk management features that you use for this property

Wired Fire Alarm
Sprinklers
Intruder Alarm
Other
None

Is the intruder alarm maintained by accredited company?

Yes
No

The name of contracted accredited company for the intruder alarm?

What type of signalling your alarm has?

Redcare
Digicom
Bells only
Other

Is the alarm connected to the Police response?

Please specify level of response

Are your sprinklers maintained by Loss Prevention Certification Board approved company?

Yes
No

Sprinklers accreditation details:

Estimated value of the building? (Including fixed glass, landlords' fixtures/fitting)

Estimated value of general contents

Estimated value of the computers and electrical equipment

Estimated value of the business stock

Estimated value of the portable equipment

Limit of indemnity annual aggregate (£)

Limit of indemnity any one loss (£)

Does the business keep any money in Safe or Strongroom on the premises?

Yes
No

Please provide the Safe Make - Model - How is it secured?

Preferred limit of indemnity cover that you require for Public / Products Liability

2 Milions
5 Milions
10 Milions
Extra layer

Have you had any insurance claims within the last 5 years?

Yes
No

Please provide: The date of the claim, Cause of the Claim, The Claim Amount & the Outcome:

Any addition information?

GDPR Agreement *

I consent to having this form submitted so Prestige Insurance Brokers (UK) Ltd can respond to my inquiry.

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© 2025 Prestige Insurance Brokers (UK) Limited - Appointed Representative of TEn Insurance Services Ltd, trading as Eleven, which is authorised and regulated by the Financial Conduct Authority (FRN 314593)