| * Denotes Mandatory Field |
* Contact Name
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* E-Mail Address
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* Telephone Number
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| * Correspondence Address |
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* Post Code
|
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Trading Name
if applicable |
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* Company Status
|
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| * Risk Address |
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| |
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* Post Code
|
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Current Insurers
|
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| Date Due/Cover Required |
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How is the property occupied (i.e. state OCCUPIERS trade)
If any portion of the property is occupied for residential purposes i.e. Flat
above a shop, then select a secondary/third trade of "Private Dwelling/Flat"
If you are unable to find the correct trade in the list below we may still be able
to provide you with a quotation, please use our Commercial Enquiry Form and
we will contact you to obtain further details.
|
| * Main Trade |
|
| Secondary Trade |
|
Third Trade
|
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* Appox Year Built
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* Property Construction
|
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* Roof Construction
|
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* What percentage of the
roof is flat felt on timber
|
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* Floor Construction
|
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* Stair Construction
|
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* Listed Building
|
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* Any history of Subsidence
Ground Heave or Landslip
in the property or
surrounding area
|
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* Have you made any
claims in the past 5 years |
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If Yes, give details
|
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* Buildings Sum Insured
|
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Landlord's Contents
If Required |
|
Monthly Rental Income
If Loss of Rent Cover Required |
|
| Any Additional Information |
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