Armoured Car / Cash in Transit Questionnaire

Return to:-David Cobb

HSBC Insurance Brokers Limited

Specie Division

Bishops Court, 27-33 Artillery Lane, London E1 7LP

Tel: 011 44 20 7247 5433 Fax: 011 44 20 7661 2175

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Proposal for Armoured Car Operators

Before any question is answered, read carefully the declaration at the end of this proposal that you are required to sign. Tick Yes/No boxes as appropriate.

General Information

1  Full Name of proposer(s)

2  Name under which you trade

3  List the address of all your premises associated with your business

(Continue on a separate sheet if necessary)

a.______

b.______

c.______

d.______

e.______

4  Names of Officers and Owners

a.______

b.______

c.______

d.______

5  How long have you been in business

a.______
6 Please list any names under which you have previously traded.

.______

.______

.______

7  Have you been or are you currently insured ? Yes______No______

If ‘Yes’, please state :

a. Name of insurers ______

b. Brokers or agents ______

c. Renewal Date of Insurance ______

8 Has any insurer declined, refused to renew or requested special terms to insure you or any director, principal or partner in this or any other business ? Yes______No______

If ‘Yes’, please give details

.______

.______

.______

Loss History

9 In the last 5 years have you or any predecessor company suffered a loss or losses, whether covered by insurance or not and if insured, whether a claim was paid or not ? Yes______No______

If ‘Yes’, please give details:

Date of Loss Circumstances of Loss Amount

(Continue on separate sheet if necessary)

Insurance Details

Amounts Insured

10  What limits of insurance do you require for insured property ?

a. On premises specified in the schedule In Vault CAD______

b. Out of Vault CAD______

c. Whilst in armoured vans CAD______

d. Pavement risk CAD______

e. ATM Servicing (MAX any one ATM) CAD______

C.I.T / Vault Operations

11 What was your annual gross revenue from all operations for the last 12 months which will be covered within the scope of this insurance

a. Last 12 Months CAD______

b. Next 12 Months (Estimate) CAD______

12  What was the approximate total face value of the cargo carried by your armoured car operations in the last 12 months

CAD______

13  What are the total values exposed at the premises

(continue on a separate sheet if necessary)

Vaults CAD______

Out of Vault CAD______

Please give details: :______

:______

:______

:______

14  What are the maximum values carried in any one vehicle at any one time

Maximum CAD______

Average CAD______

15  What is the maximum value which is at risk at any one time outside an armoured vehicle off the premises

Cash CAD______

Other valuables CAD______

16  Do you separate all cash holdings

for your customers ? Yes______No______

17  How often are vault audits performed ?

Cash :______

Coin :______

Coin Operations

18  Do you count and roll coin ? Yes______No______

19  What is the maximum and average value of coin on your premises

Maximum CAD______

Average CAD______

ATM Operations

20  Do you;

a. Perform first or second line maintenance of ATM’s ? Yes______No______

b. Replenish or collect deposits from ATM’s ? Yes______No______

21  Approximately, how many ATM’s do you service ?

(a) First or second line ______

(b) Replenishment / Deposit collection ______

22  What entry systems are used for the ATM’s ? (e.g. Mas-Hamilton, Code & Key)

System How many machines

______

______

______

23 Do you have sole access to and control over other ATM’s Yes______No______

Physical Security

24  Please state make, model, construction and U.L.C.rating of your vaults and safes

Vaults:

Construction / Size / Weight / Door Make / U.L. Rating

Safes:

Make / Model / Size / Weight / U.L. Rating

25 Please specify all alarm systems on your premises. Attach copies of U.L.C certificates for each of the systems

Premises 1

U.L.C Extent / Coverage and grade / Type of system
e.g. Central station / Alarm monitoring system
Alarm 1
Alarm 2
Alarm 3

Premises 2

U.L.C Extent / Coverage and grade / Type of system
e.g. Central station / Alarm monitoring system
Alarm 1
Alarm 2
Alarm 3

Premises 3

U.L.C Extent / Coverage and grade / Type of system
e.g. Central station / Alarm monitoring system
Alarm 1
Alarm 2
Alarm 3

26 How many hold up buttons are there on the premises ______

27 How many members of your organisation have been entrusted with

a. Keys ? ______

b. Alarm codes ? ______

c. Vault / Safe combinations ? ______

28 How often are the combinations changed ? ______

29 Do you practice remote or dual control for opening and closing of vaults and safes ? Yes_____ No_____

If ‘No’ Please specify

:______

:______

Procedures and Manning

30  State the number of people employed in each category

Full Time Part Time

a. Management ______

b. Supervisory ______

c. Office / Clerical ______

d. Sales ______

e. Crewmen ______

f. Mechanics ______

g. Vault custodian ______

h. Others ______

31 Will your premises be manned 24 hours a day ? Yes______No______

Please give details :

:______

:______

32 What is the minimum number of personnel on duty at your premises ?

a. During closed periods ______

b. During business hours ______

c. How many will be armed ______

33 Are all your vaults and safes shut, locked and alarmed outside of business hours ? Yes______No______

34  Do you require your employees to submit to any of the following tests ?

a. Medical Yes______No______

b. Polygraph Yes______No______

c. Psychological Yes______No______

d. Narcotics Yes______No______

Others, please specify.

:______

35  When screening new employees, do you conduct any of the following checks ?

a. Prior employment references Yes______No______

b. Credit Yes______No______

c. Neighbourhood Yes______No______

d. Criminal records Yes______No______

e. Driver records Yes______No______

Others, please specify

:______

:______

36  How much training is given to an employee prior to active service ?

:______

37  How much training is given during employment per annum ?

:______

Crew

38  What is the minimum number of crew (incl. Driver) who will ride in each vehicle on operations ?

Up to a limit of CAD No. of Crew
Up to a limit of CAD No. of Crew
Up to a limit of CAD No. of Crew

39 Are all crew members armed ? Yes______No______

40 When armoured vehicles are not in a secured and guarded concourse, will at least one member of the crew stay in each vehicle during operations, regardless of circumstance? Yes______No______

41  What communication systems do you have on your vehicles ?

:______

:______

:______

:______

42  Do you have an emergency plan in place ?

Please give details : ______

43 Do management regularly monitor operational crew performance and retain such records on file ? Yes______No______

44 Do you carry out random credit checks on existing employees ? Yes______No______

Trade References

45  Please give names and addresses of 2 referees from your trade.

Name
Address
Name
Address

46  Are you members of any trade associations ?

Please specify :______

Financial

Please attach the latest audited financial statement, if available.

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Proposal for Armoured Car Operators

47. Specify below all vehicles armoured or otherwise to be insured hereunder.

Make of Vehicle / Model and Year / Specification of Armour / Is vehicle fitted with 2-way radio / What type of security systems are fitted ? / Is there a bulkhead that fully protects at least 1 member of the crew whilst any one door to the armoured vehicle is opened ? / Are vehicles maintained by assureds staff on assureds premises ? / Licence plates and registration number
Yes / No / Yes / No / Yes / No
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(Please continue on a separate sheet if necessary)

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Proposal for Armoured Car Operators

DECLARATION

Important, you must read this carefully before signing below.

To the best of my knowledge and belief the information provided in connection with this proposal, whether in my own hand or not, is true and I have not withheld any material facts. I understand that non disclosure or misrepresentation of a material fact will entitle Underwriters to avoid this insurance.

(A material fact is one that is likely to influence acceptance or assessment of this proposal by Underwriters. If you are in any doubt as to whether a fact is material or not, you must disclose it in the space below)

I understand that the signing of this proposal does not bind me to an insurance contract but agree that, should a contract of insurance be concluded, this proposal and the statements made therein shall form the basis of the contract.

Signature of proposer
Date

You should keep a record (including copies of any letters) of all information supplied to Underwriter for the purpose of entering into this insurance. A copy of your completed proposal will be available (on request) provided the insurance is effected.

You must inform us of any change in circumstances that will materially affect this insurance.

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