Certificate Text


(Where required by regulation 5 of the Employers’ Liability (Compulsory Insurance) Regulations 1998 (the Regulations), one or more copies of this certificate must be displayed at each place of business at which the policyholder employs persons covered by the policy)

1. Name of policy holder: Ben Harman
2. Unique Market Reference: B0609THISCLIB2015
3. Policy Number: 04061077419
4. Date of commencement of insurance policy: 21/01/2016 5. Date of expiry of insurance policy: 20/01/2017

We hereby certify that subject to paragraph 2

  1. the policy to which this certificate relates satisfies the requirements of the relevant law applicable in Great Britain, Northern Ireland, Isle of Man, Island of Jersey, Island of Guernsey, Island of Alderney; or any offshore installations in territorial waters around Great Britain and its Continental Shelf (b): and;
  2. (a) the minimum amount of cover provided by this policy is no less than £5 million (c); or
    (b) the cover provided under this policy relates to claims in excess of [£ ] but not exceeding [£ ].
  3. the policy covers the holding company and all its subsidiaries

Signed on behalf of those Lloyd’s Underwriters subscribing to the above policy and other insurers as defined in the policy (Authorised Insurers)

Joint Active Underwriter of Syndicate 4444/958


  1. (a)  Where the employer is a company to which regulation 3(2) of the Regulations applies, the certificate shall state in a prominent place, either that the policy covers the holding company and all its subsidiaries except any specifically excluded by name, or that the policy covers the holding company and only the named subsidiaries.
  2. (b)  Specifically applicable law as provided for in regulation 4(6) of the Regulations.
  3. (c)  See regulation 3(1) of the Regulations and delete whichever of paragraphs 2(a) or 2(b) does not apply. Where 2(b) is applicable, specify the amount of cover provided by the relevant policy.

NOTE: The information below this line does not form part of the statutory certificate.
Those Underwriters at Lloyd’s on whose behalf this certificate is issued require the following information to be entered by the issuing intermediary:

Name and address of issuing intermediary: Thistle Insurance Services Limited. The St Botolph Building, 138 Houndsditch, London, EC3A 7AW.

Thistle Underwriting is a trading style of Thistle Insurance Services Limited. Lloyd’s Broker. Authorised and Regulated by the Financial Conduct Authority. A JLT Group Company. Registered Office: The St Botolph Building, 138 Houndsditch, London, EC3A 7AW. Registered in England No 00338645. VAT No 244 2321 96.