Name of Organisation:
Correspondence Address:
Plant Address:
Contact Name:
Contact Email Address:
Please retype the Contact Email Address here, to reduce
the risk of errors:
Contact Telephone No.:
Please note that the following is not exhaustive and
concentrates on common items of statutory Plant and Machinery associated
with a Voluntary Organisation type Premises. For information in respect
of items not listed, please contact Keegan & Pennykid (Insurance Brokers)
Ltd.
Boiler and Pressure Plant
Item
Quantity
Steam Boilers, Steam Ovens, Autoclaves
Canteen Steam Boiler
Hot Water Heating Boilers
Air/Oil pressure Vessels (commonly found associated with compressor units)
Other Pressure Systems
Lifting Equipment
Item
Quantity
Passenger/Goods Lift
Stair Lift
Bath Hoist
Vehicle Tailboard Lift
Food Hoist/Dumb Waiter
Motor Vehicle Lifting Table
Fork Lift Truck
Chain Blocks
Lifting Tackle (chains, slings, jacks, shackles, etc.)
Window Cleaning Apparatus
Electrical Plant
Local Exhaust Ventilation (COSHH Regulations
1989)
Please provide details of:
the number of extraction units involved:
Electricity at Work Regulations 1989
What is their purpose? legal requirements
What does the law say? legal responsibility
How do you ensure safety? competent person
How can Royal & SunAlliance help?
Why it pays to use Royal & SunAlliance
What next?
Type of Inspection
Information Required Quantity
Electrical Wiring Installation
Total square footage of premises
Fixed Electrical Items
HP/KW of each item
Portable Appliances
Total number of items
Microwave Ovens
Total number of items:
Emergency Lighting Installations
Total number of luminaires:
Please check the wording of this Proposal and the data
you have entered carefully before proceeding by clicking on the 'continue
to next stage: final check' button, below. Clicking on the button will
not submit your details yet, but will cause another page to
load.
The new page that loads will give you a chance to check your data again,
and if you need it you will get another opportunity to make changes
before finally sending the data.
If you notice an error shortly after sending the data (when you see
the page that invites you to print the submitted data out for your records)
you can resubmit a corrected version. After submitting, you can try
using your browser's Back button to return to the form. If you are lucky,
the data might still be displayed, which would save you typing it all
in again.
If you resubmit in this way, please also indicate this here:
Are you resubmitting this form after making a change
to a recent submission?
If you only notice an error later and it is too late
to go back and resubmit, or you find that the data has disappeared from
the form when you return to it, please make a copy of your printed record
and fax it to us along with an indication of the change(s) you wish
to make.
Alternatively, please call us on (0131) 225 6005 and
explain the change(s) you would like us to make for you.
Please note that in such circumstances we may have to send you a form
to fill in on paper and sign in order to confirm changes.
