Professional Third-Party Declaration Form

Please complete this form and provide a copy of your insurance certificate and/or policy schedule as proof of adequate insurance cover for your participation in an FFH-organised event at Highfields School, London Road, Balderton NG24 3AL (ffh@highfieldsschool.co.uk)

Date of Event you are attending

Third Party Business Name

Third Party Address

Third Party Email

Third Party Phone

Public Liability Section

Insurance Provider

Policy Number

Renewal Date

Limit of Indemnity

Equipment Requirement

e.g. tables, chairs, electrical points

Please detail all equipment being brought onto site? Can you confirm that these items have all required safety checks (e.g. PAT testing, PIPA)

Products

Please describe the products you will be selling

Services

Please describe the service you will be providing

Please confirm that you have completed a risk assessment for this activity and be prepared to show completed risk assessment to event organisers.

Yes

Provision of Food (applicable to certain providers)

Please confirm all necessary parties have required Food Safety Hygiene certificates and all inspections are up to date. Please be prepared to show proof of this.

Yes

No / NA

Signature of Third Party

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Date of Form Completion

Completed declaration forms MUST be kept on file by the PTA. In the event of an insurance claim, the PTA may be expected to provide a copy to Zurich Insurance Company Ltd.