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CIVIL LIABILITY INSURANCE PROPOSAL FOR KART, QUAD AND MINIMOTO TRACKS
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Company
Broker Name
Addess
Zip Code
Town
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ORIAS Code
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Only a very complete proposal, which must be accompanied by the course certification and track plan, can enable the insurers to appraise the risk at its true value and determine the premium.
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| I - Your Organisation |
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Facility Name
Address
Manager's full name
Téléphone
E-mail
Télécopie
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| II - Your Activity |
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Specific activity (operator of kart/quad/minimoto track/driving school)
Do you hold karting/quad/minimoto competitions (challenges; company trophies)
Activity established in
Indoor or outdoor track
Number of tracks
Length of the track(s) (attach a plan of the track(s) and facilities)
Track certification (attach certification issued by the administrative and/or sporting authority)
Number of permanent employees
Temporary
Most recent turnover
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| III - Your Premises |
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Are you the owner or the lessee of the premises
If lessee, partial or total
Nature of construction
Nature of roofing
Developed surface area of premises
Spectator protection along the tracks
Fire protection (extinguishers
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Presence of facilities such as refreshment area, amusement games, etc
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| NB: attach detailed plan of the track(s) and facilities |
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| IV - Your karts, squads, minimotos |
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Number of karts/quads/minimotos owned by the prospective buyer
Type and size of the karts/quads/minimotos
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Maximum number of karts/quads/minimotos operating simultaneously on each track
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Track 1
Track 2
Track 3
Track 4
Track 5
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IN THE EVENT OF OMISSION, INACCURACY OR FALSE STATEMENTS, THE ANSWERS TO THIS PROPOSAL-QUESTIONNAIRE ARE SUBJECT TO THE SANCTIONS ESTABLISHED BY ARTICLES L 113-8 AND L 113-9 OF THE INSURANCE CODE.
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Done in
on dd/mm/yyyy
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Broker
Applicant
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If you wish, you can download Contract in pdf format
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Proposal Demonstration Concentration
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