ACY Risk Management Self-Assessment Form
The following information enables us to reward good insurance risk features and allows us to offer our most competitive terms. If you choose to complete them, you may qualify for a discount off your premium.

NOTE: you do not have to complete this questionnaire but if you do the information will be recorded and produced with the policy documentation.
  • If available

  • Please check the box to confirm if you comply with these statements:
  • You have documented Fire Risk Assessments which will be reviewed and updated at least once a year, and will complete a fire inspection tour of the premises at least once a year and additional inspections as needed to ensure safety standards are maintained
  • You have a written and recorded maintenance plan for the building that includes regular inspections of flat roofs, gutters, downpipes, drains and the general fabric of the building at least once a year, and a log for any defects found and any repair work is completed as soon as possible, and any external storage of waste within 10m of the buildings in locked and lidded metal bins
  • You have fixed electrical inspections undertaken and certificated by NICEIC/ECA/NAPIT(full Scope) contractors every 5 years (or as otherwise recommended in the last inspection), and Portable (electrical) Appliance Testing (PAT) undertaken at least once a year, and any gas appliances maintained and inspected by a GasSafe registered contractor at least once a year
  • You have a training plan for new and existing employees or volunteers, that: is written and recorded, and includes induction, task specific and refresher training, and formally identifies the training needs for all employees and volunteers including any agency workers, and is in an appropriate format, and ensures that all trainees are assessed to confirm they have understood the training received and acquired the level of competency necessary, and is appropriate to the activities they carry out and undertaken before each activity begins
  • Your health and safety policy: is complete, and sets out the specific responsibilities of those required to implement them, and identifies specific arrangements for the managing of particular health and safety hazards, and is communicated and accessible to employees, volunteers and others who may need it, and is reviewed at least once a year
  • As part of your health and safety policy, your risk assessment(s) for your business: is complete as required by statute, and has been developed with those with practical knowledge of the working practices, and identifies the current precautions in place and any others that might be required to comply with statutory requirements and official guidance, and considers all those who may come into harm i.e. full, part-time, night or lone workers, contractors, vulnerable or young people and the disabled

  • Our terms and conditions can be read on our website at www.norrisandfisher.com/terms - Norris and Fisher (Insurance Brokers) Ltd complies with the requirements of the Data Protection Act (DPA) 1998 and General Data Protection Regulations (GDPR) 2018. This Act places legal obligations upon Norris and Fisher (Insurance Brokers) Ltd in respect of the way we collect, review, distribute and store personal data.