Commercial

Please complete the form below as accurately as possible and submit to us for a quote.

Required fields are in bold

     

About You
1.

Contact name

     
2.

Correspondence address

 

Postcode

     
3.

Telephone number

     
4.

Email

     
5.

Role

Policyholder
6.

Name of insured

 

The Insured does not reside in the United Kingdom

Property Details
7.

Risk Address

 

Postcode

     
8.

Construction Details

  
 

• Building construction:

 

• Roof construction:

 

• Floor construction:

 

• Stairs construction:

     
9.

Rebuild cost of property (declared value)

     
10.

Date of Construction

     
11.

Grade listing
     
12.

Number of floors

     
13.

Number of lifts
(If the building has no lifts, please enter 0)

     
14.

The property has an oil tank

Commercial Occupation
15.

Occupation Details

16.

Annual rent figure

 

Period

Residential Occupation
17.

The property has residential portions

18.

Number of flats
If the property has no flats, or has a different kind of residential accomodation, please enter 0.

19.

Other residential dwellings
Please specify both the number and the nature of the other residential dwellings.

20.

Occupation details

Claims & Incidents
21.

Last 5 years' history of all Claims, Incidents, and Losses
(If none, please state so)

     
22.

Has the property ever suffered from any of the following?

  
 

Subsidence/Heave/Landslip

 

Fire

 

Flood

 

Cracking

 

Details
(If you answered yes to any of the above)

Previous Insurance
23.

Existing Insurers

     
24.

Insurance Renewal Date

     
25.

Premium

 
  • Leave this field blank if this is your first policy.
  • Include all applicable taxes.
  • Use the combo box to the right to specify whether this is the Expiring premium or the Target premium.
 

This premium figure includes:

Terrorism Cover

Engineering Cover
26.

Additional details


Please select any add-on covers you would like to be included in your quote:

Terrorism Cover

Engineering (Lift Insurance & Inspection) Cover

You will have a chance to confirm which add-on covers to include if and when you take out your policy.