DETAILS : |
|
|
Contact Name: |
Business/Trading Name: |
|
|
|
|
Description of Business/Trade: |
|
|
|
|
|
|
Address & Postcode : |
|
|
|
|
| Company Status: |
|
|
Contact
Telephone: |
Mobile
Number: |
Fax
Number: |
|
|
|
|
| Email
Address: |
|
|
|
|
|
| How
do you wish us to contact you? |
|
|
| |
|
|
COVER REQUIRED:
|
|
|
Buildings (Reinstatement Cost) |
£
|
|
Please confirm construction of building is Brick / Stone and roofed with slate / tiles? |
|
|
| Please confirm your office is fully self-contained? |
|
|
| Please state method of access control to your office premises. |
|
|
| General Contents : |
£
|
|
Tenants Improvements/Fixtures and Fittings: |
£
|
|
Computer Equipment/Electronic Business Machines : |
£
|
|
Do you require Legal Expenses Insurance? |
|
|
| Any other cover required? |
|
|
|
|
| Is there an alarm? |
|
|
| Type of Signaling? |
|
|
| How long have you been trading? |
|
|
| Number of Claims in last 5 years? : |
|
|
| Value of Claims (if applicable) |
£
|
|
| Current Insurer: |
|
|
| Renewal Date / Start Date: |
|
|
| Renewal Premium: |
£
|
|
Standard cover includes:
Fire, Theft, Water Damage, Riot, Malicious Damage etc
Public and Employers Liability
Business Interruption |
|
|
| |
|
|
