Correspondence Details
Name
Postcode
Telephone
Email
Business Details
Name
Postcode
Trade / Business
Years trading
Years experience
Contents section
Tenants Improvements Sum Insured
Computers (not stock) Sum Insured
Other Electronic Equipment Sum Insured
Documents Sum Insured
Shop Front Sum Insured
Fixtures & Fittings Sum Insured
Wines & Spirits Sum Insured
Cigarettes & Tobacco Sum Insured
Attractive Stock (jewellery, etc) Sum Insured
Other Stock in Trade & Goods In Trust Sum Insured
Additional cover
Is Money cover required?
No
Yes
£
Are the premises protected by a NACOSS approved ALARM?
No
Yes
Is your alarm connected to a central station
No
Yes
Does the alarm have REDCARE
No
Yes
Is Buildings cover required?
No
Yes
£
The standard cover is Fire and Perils, do you wish to extend cover to include Accidental Damage?
No
Yes
What year was the property built?
Is the property of standard construction?
No
Yes
Is there any flat roof
No
Yes
Is Business Interruption required?
No
Yes
£
Is Outstanding Debit Balances cover required?
No
Yes
£ Public Liability level of indemnity required
£1,000,000
£2,000,000
Is there any work away from premises
No
Yes
Additional details
Have you or any director or partner incurred any loss, destruction, or damage or made any claim or had any claim made against you in the last 5 years?
No
Yes
Does any other business occupy or operate from these buildings?
No
Yes
Are any External Doors NOT secured by 5 lever mortice deadlocks conforming to BS3621?
No
Yes
Are any Accessible Windows NOT secured by key operated windows locks?
No
Yes
Final details
Have you been convicted of, or in the course of being charged with, any offence (excluding driving offences)
No
Yes
Have you been declared bankrupt or been a director of any company that went into liquidation
No
Yes
Have you had any insurance declined, cancelled, refused or had any special terms applied by any Insurer for the risks proposed
No
Yes
Please add any additional information that may be required for your quotation in the space below
