| Name |
|
| Date
of Birth |
|
| 1st line of correspondance
Address |
|
| Postal Code |
|
| Phone no. |
|
| Mobile Phone no. |
|
| E-mail |
|
| 1st
line of Shop Address |
|
| Postal Code of Shop Address |
|
| Is the business a Limited Company? |
|
| What is your Trading Name? |
|
| How many years trading at this address? |
|
| What is the renewal/start date you need for this policy? |
|
| What is the best quote you've had so far? £ |
|
| What is your estimated annual Turnover? |
|
| How many staff do you have? |
|
| Is there a cash machine on the premises? |
|
Min. Security: 5 lever mortise locks and lockable (or non opening) windows |
|
| Does
the property meet minimum security levels? |
|
| Does the property have an alarm? |
|
| If there is an alarm, is there a maintenance contract in place? |
|
| Is there any CCTV? |
|
| Are there any grilles or shutters? |
|
| Any other security? |
|
| Is the property brick or stone with a
slate or tile roof? |
|
| Does
the property have any flat roof area? |
|
| Any
previous claims or uninsured
losses? |
|
| Is
the property within 200m (220yds) of any water or in a flooding area? |
|
| Is
the property Listed? |
|
| Is
there any residential accommodation? |
|
| Buildings
Sum Insured £ |
|
| If you need buildings cover, please answer the following yellow questions: |
|
| Any subsidence, heave or landslip history? |
|
| Is
the property near cliffs, quarries, mines or anything of that
nature? |
|
| Are
there any trees or large shrubs within 7m (20ft) of the
property? |
|
| Fixtures & Fittings Insured £ |
|
| Electronic Equipment (Computers/Copiers etc.) |
|
| Business Equipment Insured £ |
|
| Stock Insured £ |
|
| Other Contents
Sum Insured £ |
|
| All Risks Cover £ |
|