What is your first Name:
|
|
| What
is your last Name: |
|
| Title: |
|
| What is the
company name |
|
| Street Address
line 1 |
|
| Street Address
line 2 |
|
| Street Address
line 3 |
|
| City: |
|
| County: |
|
| Postal Code: |
|
| Country: |
|
We
are only able to quote for UK based risks |
| Daytime Telephone |
|
We
may need to telephone to clarify any information |
| Evening Telephone |
|
If
you would prefer us to telephone in the evening or on a mobile please
let us have the number here. |
| Fax: Number |
|
|
| E-mail:- (Without this
the system will not quote) |
|
Communication
is normally done by e-mail. |
|
About your business |
|
| Please
describe to us exactly what your business does giving full details of
your processes and how you go about doing it. |
|
Please
give as much detail as you can. The more we understand your business,
the more likely we will be able to get a competitive premium. For
example, give details of what you manufacture and how you store and
deliver and install, giving details of all work away from the premises. |
|
About your sums insured |
|
| We need to establish your
sums insured split as follows:- |
The boxes which require
figures will accept only whole numbers. There is no need to put a £ before, or commas in the
figure or decimal points. |
Notes |
| Buildings in £ |
|
This should represent the
cost to rebuild including architects fees |
| High risks stock or items
for resale in £ |
|
Any stock of
Jewelry watches camera, furs, clothes, videos, computer equipment (for sale) |
| Please tell us in which
category they are |
|
|
| Other stock in £ |
|
|
| Work in progress or partial
made up work in £ |
|
This figure should
represent the maximum during the course of the insurance year |
| Fixtures and fittings in £ |
|
This should be items such
as shelving benches in the workshop and cupboards filing cabinets and
desk etc in the office But not electrical equipment |
| Heavy machinery other than
hand tools in £ |
|
These are items that are
not easily portable |
| Hand tools that stay in the
premises in £ |
|
You can choose to cover
your hand tools out of the premises if you wish. |
| Office electrical equipment
excluding computers and other IT equipment in £ |
|
This is items such as
telephones systems photocopiers fax machines typewriters etc. |
| Computers and other IT
equipment in £ |
|
This should exclude laptops
and other mobile equipment unless you only want it covered in the
premises only |
|
About your premises |
|
| We need to understand the
construction of the premises |
|
This is true even if we are
not insuring the building. |
| Please advise the
construction of the walls |
|
An example would be brick
metal of concrete. |
| Please advise the
construction of the roof |
|
Examples would be wood
tiles, slate, or corrugated fibre board or metal. |
| What percentage of the roof
is flat |
|
|
| What is the construction of
the floor |
|
Concrete throughout or
concrete downstairs and wood upstairs or wood throughout |
| What are your stairways
made from |
|
Metal wood or concrete |
| Is the property terraced
detached semi detached and which type of premises is it |
|
Purpose built commercial
unit converted house |
| How many stories is the
property |
|
Include a
mezzanine
floor as a floor |
| Is there a basement and
what is it used for |
|
If
it is used for storage then it will probably be a requirement that all
items are kept off the floor. |
| Roughly, how many square
feet do you have in your premises |
|
Any on a
mezzanine floor
should be included. |
| What do your
neighbours do
in their premises |
|
Please
leave in the notes section the type of goods involved if of a volatile
nature. For example if there is a firework factory next door then
it will probably impact on your insurance. |
| How do you heat your
premises |
|
You
can select more than one option by holding down the control key and
clicking on more than one option. |
| What do you have in the way
of fire extinguishers with service agreements and blankets and sprinkler systems |
|
You
can select more than one option by holding down the control key and
clicking on more than one option. |
| Do you have a maintained
alarm system and if so which category does it fall into |
|
|
| Do you have
key operated window locks or
bars on all accessible windows and do you have 5 Lever Mortise Deadlocks
on all external doors or closed circuit tv |
|
You
can select more than one option by holding down the control key and
clicking on more than one option. |
|
About cover outside |
|
| You can cover items outside
of your premises This falls into categories of all risks on items such
as Laptops tools exhibition equipment etc or Stock in transit |
The boxes which require
figures will accept only whole numbers. There is no need to put a £ before, or commas in the
figure or decimal points. |
If
you do not require this cover please leave the boxes blank |
| What
is the value of Laptops or other mobile computer equipment that you
require covered outside the premises in £ |
|
|
| What
is the value of tools that require cover outside of the premises in £ |
|
|
| What
is the maximum value of exhibition stands required on an all risks basis
in £ |
|
|
| What
is the maximum value any one load of stock for which you require cover
in transit. |
|
This
is the maximum any one load per vehicle |
| If
it is carried on your own vehicles, then please advise how many vehicles
you use at any one time |
|
|
| What
is the total value of stock carried in any one year. |
|
This
should represent the cost of replacing the Annual value of the stock in
transit. |
| Is
the cover to be UK only EEC based or world wide |
|
|
|
Cover for your
Liabilities |
|
| This
covers your liabilities to your employees which is a compulsory level of
cover, and to the public for either just your actions or for your
actions and products. |
There
are 4 boxes. The first is for the wage roll in £ the second for the number of
people employed in this category. The third is for the % work away
and the 4th is a free form box to describe their duties |
We
ask for a split in the wage roll because some activities attract higher
rates than others. The more we know about how you operate the more
likely we are to arrive at an acceptable premium. |
|
What is your management and
clerical wage roll, the number of people that you employ in this section
and the % of their time that they work away from your premisies. |
|
This
should include all those in sedentry occupations including sales people.
If one person work in two categories, use a % for each |
|
Employees using fixed heavy
machinery |
|
This
is the type of machinery which is not easily removable, such as bench
saws and lathes etc. |
| Employees
doing lighter manual jobs |
|
Such
as painters woodwork using only hand tools metal work etc. |
| Employees
doing assembly etc |
|
This
would involve only the use of light tools such as a screw driver etc. |
| What
is your estimated turnover in the next twelve months |
|
|
| Do
you work at heights? If so what is the maximum height. |
|
This
will include the use of steps or ladders. |
| When
working away, do you work underground? If so to what depth. |
|
|
|
Cover for Loss of Profits |
|
| This
covers losses which result from your inability to trade as a result of a
fire or the like at the place of manufacture. |
|
If
this cover is not required, then please leave the boxes blank |
| Please
advise what your gross profits for the next year will be. |
|
Gross
profits are defined as turnover less cost of production of that
turnover. Your wage roll should not be deducted as a cost of production
as you will still have to pay your permanent staff after a fire. |
| How
long would it take you to be up and trading again after a major fire or
the like |
|
We
call this the indemnity period. It will be the amount of time that the
policy will pay for losses following a claim |
|
Extra covers |
|
| Do
you require money cover? |
|
|
| Do
you require Glass cover? If so please advise the value to replace the
glass in your premises |
|
|
|
Some extra questions |
|
| For
how many years have you been trading |
|
|
| Who
are your current insurers |
|
We
need this as we would not wish to approach your current insurers. |
| When
is your renewal date |
|
Insurers
are generally very busy and need to know when the request needs to be
completed by |
| Please
advise the renewal premium that has been offered to you or the best
premium quoted so far. |
|
We
need to know this as we do not wish to waste insurers time. If you have
something that is competitive, we will tell you. |
| Is
your premises especially exposed to any risk for which you are applying
for insurance |
|
For
example are you premises on the edge of a cliff, or are they in an area
which has been flooded regularly. |
| Have
you had any claims in the past 5 years. If so please use box 1 for the
date, box 2 for the amounts and box 3 for the details of what happened. |
Claims |
If
you have had more than two claims in 5 years then please give the same
details in the notes box of all other claims. |
| Claim
1 |
|
|
| Claim
2 |
|
|
|
Further Information and
Notes |
|
| All
insurance policies require you to disclose anything that may be relevant
to underwriters. Please use this box to give us that information and
make any additional notes which you may wish to give to clarify the
situations above. |
|
Examples
of relevant information would be if you have been convicted of arson or
been made bankrupt, or spent time in jail or involved in anything that
insurers may not been pleased about. |
|
To help us
understand our enquiries
|
|
| Please advise which
search engine or connection you used to find our site |
|
This
will help us to understand where our enquiries come from. |
| Please advise the word or
words on which you searched to find our site. If you used other engines
which did not send you to our site please also list below. |
|
We much appreciate this
additional information. Thank you. |
|
Please press the send button
|
|
A quotation will be
prepared for you. We will tell you how on the next page.
|