BUSINESS INSURANCE QUOTES
 
 
1. Name of Proposer and Trading Title:
2. Address of the premises:
Post Code:
        Tel. Number:  
e-mail (if you have any):
3. Description of Business:
4. Date Established:
5. Type of premises:     If other, please state:
6. Does your premises have it's own lockable entrance: Yes No
7. THE CONSTRUCTION OF PREMISES (ie: Brick walls, Mild steel roof)
7.1 Is there a partial / full flat roof Yes No
If "Yes" describe in detail:
7.2 Type of heating at premises:
8. THE LOCATION OF PREMISES:
8.1 If other, please state:
8.2 Approx distance from Police Station (Miles):   Approx distance from Fire Station (Miles):
9. YOUR BUSINESS :  
9.1 Please provide a full description of all processes carried out:
9.2 Are any processes involving the use of heat carried out Yes No
If "Yes" describe in detail:
9.3 Is any work carried out away from the premises Yes No
If "Yes" please describe in detail the work carried out:
9.4 Do you export? Yes No
If "Yes" do you export outside the UK: Yes No
If "Yes" indicate areas:
10. SECURITY AND FIRE PRECAUTIONS  
FIRE  
10.1 Are the premises fitted with a: Fire alarm : Yes No
  Sprinklers: Yes No
  Fire Extinguishers: Yes No
10.2 Are there any rivers or watercourses near the premises Yes No
If "Yes" please give full details
10.3 Physical Security:
11. BURGLAR ALARM  
11.1. Is there a burglar alarm under your sole control Yes No
If "Yes" please state:
 
12. INSURANCE HISTORY  
12.1 Have you had any previous insurers: Yes No
12.2 Have you ever been declined, cancelled, refused or special terms: Yes No
If "Yes" please give full details
12.3 Have you had any claims: Yes No
If "Yes" please state here:  
Date of claims:
What happened:
Total Payment
1.
2.
3.
4.
 
13. SUMS INSURED  
        SUM INSURED
Buildings (including outbuildings): £
Stock in trade: £
Stock in trust (customers goods): £
Plant Machinery: £
Fixtures & Fittings: £
All other contents: £
Computer Systems: £
Loss of rent (12 or 24 months) Yes No
Do you require Accidental Damage to apply on contents? Yes No
Do you require Accidental Damage to apply on buildings? Yes No
14. LOSS OF PROFITS  
Gross Profit: £
15. EMPLOYERS LIABILITY (Please give estimated annual wages)  
Salesmen, Reps and Drivers: £
Clerical and Admin Wages: £
Employees using woodworking machinery: £
Employees using metalworking machinery: £
All other employees: £
16. PUBLIC AND PRODUCTS LIABILITY  
Estimated turnover: £
Of which work away: %
Do you use heat away? Yes No
If "Yes" details must be given here:
17. GLASS BREAKAGE  
Value of Glass £
18. MONEY  
Estimated annual carryings: £
Limit required in safe: £
Limit required on premises during business hours: £
Limit required in transit: £
Any other money required (detail)
19. BELONGINGS OUTSIDE PREMISES  
 
 
Description:
Sum Insured
1
£
2
£
3
£
 
  Geographical Limit: Premises
UK and EUROPE
20. GOODS IN TRANSIT    
Limit required any one vehicles: £
Numbers of vehicles:  
Estimated annual carryings: £
     
Do you want a Quote in:   24 hrs working 3 Days working 5 Days working
     

 

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