Exhibition Insurance Claim Form

Event Details

Company Name:
Company Address:
Telephone:
Fax:
Contact Name:
Event Name:
Venue Name:
Venue Address:

Claim Details

Details of incident:
Date of Incident:
Category of Claim:

Property Damage:

Please provide documentary evidence to support your claim i.e. Original purchase receipts and a written estimate for the replacement items or if damaged, a repair estimate

Item	Age	Cost To Replace/Repair	Amount Claimed










		Total:

For stolen items please provide the following:
Date and Time reported to police, Police Ref No. and Address of Police Station

Exhibition Expenses

Please list and submit all expense invoices and provide details of any further accounts to follow:

Detail of Expense	Amount	Invoice





	Total:

Public Liability

Details of any injuries:
Name and addresses of witnesses:
Details of Damaged property/clothing etc:
Total Claimed:

Claim Conditions:

The Company is obliged to notify insurers of any incident that may give rise to a claim under this insurance within 30 days of said incident.

The Company is obliged at all times to protect the interest of insurers. If the Company is entitled to claim compensation under any other insurance please give full details below:

This claim is subject to the limits of indemnity, excesses and terms and conditions of the original policy.

Decleration

I hereby declare that to the best of my knowledge and belief these particulars are correct in all respects.

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