Public liability insurance Guidance Note
Belfast City Council requires that a valid and adequate policy of public liability insurance must be
held in respect of licensed pavement cafés in Belfast. The policy must be valid and effective
throughout the operational period of the licence.
The name of the insured must be the same as that of the applicant or licence holder or must
otherwise specifically state that such person is insured in respect of public liability risks (death or
injury) arising from or consequential to the provision of a pavement cafe on the identified
Those licence holders who have not had a new licence issued at the date of expiry but who
continue to operate a pavement café pending a renewal will be required to produce an insurance
policy covering any intervening period.
Declaration of public liability insurance
Applications for a pavement café licence must be accompanied by a declaration of
public liability insurance as set out on the back of this guidance.
The applicant must complete Part1 first and then it must be given to your insurance
company/broker for them to complete and endorse Part 2 of the form, before returning it to us.
In place of an official stamp we will accept a cover letter on headed paper from your insurance
company, or your insurer can e mail a scanned copy of the form directly to us.
When you need to send us your declaration of public liability insurance
For a Grant application this declaration form must be completed and returned before the licence
is granted. We will tell you when we are ready to grant your licence and that the declaration is
You will need to send us a new declaration form annually for the duration of your pavement café
licence and when you make a Renewal Application you must also include a new declaration form.
A new declaration may also be required with a variation application, for example if you increase
the size of the pavement café.
Note: Please keep a copy of the completed declaration on the reverse of this guidance for reference
Pavement café licensing during
COVID19 pandemic
Part 1 To be completed by the APPLICANT before forwarding to the insurance broker
I (applicant) __________________________________________________________________
As the (please tick)
Owner Club Secretary Partner
Director (please specify company name) _________________________________________
Other - (please specify) ________________________________________________________
Of (business address) _________________________________________________________
Have applied for a Pavement Café Licence for the premises known as and situated at:
Part 2 To be completed by the INSURANCE COMPANY/BROKER
We hereby confirm that we have read the declaration in Part 1 and further confirm there is, in force, a
policy insuring the applicant in respect of any liability which may be incurred by him in respect of the death
of, or bodily injury to, any person on or about the premises which is being used for a pavement café as
indicated above.
Current Insurer: __________________________________________________________________
Effective Dates: From: _____________________ To: __________________________________
Current Limit of Indemnity: _________________ Policy No: _____________________________
Restrictive endorsements (if any): (please provide copy of policy conditions) Official Stamp
Name (please print): ________________________________________
For and on behalf of: _____________________________________
Signed: _______________________Chief Date: _______________
Note: In place of official stamp we will accept a cover letter on headed paper from insurance company, or your
insurer can e mail a scanned copy of this form directly to us.
Place and Economy Department, Building Control Service
Ground Floor, 4-10 Linenhall Street, Belfast BT2 8BP
Phone 028 9027 0650 E-mail
Pavement café declaration of public liability insurance
click to sign
click to edit
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