Commercial Property Insurance Quotation Form

For UK Customers Only

Please insert your details here and one of our business advisers will contact you shortly.

This form is designed for quotes for Commercial Property Owners who wish to insure their commercial buildings only with the option to include property owners liability, loss of rent, etc.

For assistance with the completion of this form or if you have any queries, please phone us on 01623 641 386.

Proposers Details

Owner(s) Of The Property
Proposers Name(s) (incl. all partners' names if partnership):
Limited Company Name: (only if a Ltd. company owns the building)
Ownership Status:
Proposer's Correspondence Address:
Postcode:
Daytime Telephone No.
E-Mail Address:
Proposers History
Has any insurer ever refused, declined, cancelled or imposed special terms?	Yes No
If yes, please provide details:
Have you, or any other partner or director ever been convicted of or charged with any criminal offence?	Yes No
If yes, please provide details: (i.e. type of conviction(s), date of conviction(s), length of custodial sentence or details of any fines imposed, etc.)
Have you, or any other partner or director ever had any county court judgements or ever been declared bankrupt or insolvent?	Yes No
If yes, please provide details: (i.e. CCJ details, date of bankruptcy/insolvency, amount of bankruptcy/insolvency, date of discharge, etc.)
No. of years operating as a property owner?	years
Do you operate your own business from these premises?

Property Details

What date was the property purchased?	(dd/mm/yyyy)
Type of property to be insured: (e.g. offices, shop, pub, industrial unit, etc.)
Risk Address
Address of property to be insured:
Postcode of property to be insured:
Risk Details
Trade/Business of Main Tenant(s): (please state if unoccupied)
Trade/Business of any other occupancies with whom you share your premises (if applicable):
Approximately, what year was the property built?
Is the property a listed building? (e.g. grade I, II, II, etc.)*
Is the property in a good state of repair and maintained?	Yes No
If no, please provide details:
Has the property ever suffered from subsidence or flood damage?	Yes No
Please provide details of the damage: (e.g. type of damage (flood, etc.), date of damage, amount of damage, etc.)
Occupancy Details
Is there any residential accommodation at the business premises (e.g. flat above, etc.)?	Yes No
Please confirm the tenancy type:
Are any of the area's of the building unoccupied?	Yes No
What is the percentage that is unoccupied?	%
Which floor is unoccupied?
How long has it been unoccupied?
When is it anticipated that it will become re-occupied?
Heating / Electrics
How is the property heated? (e.g. gas, electric, oil, etc.)
Is there a current IEE electrical certificate?	Yes No
Construction
Property details:
Number of storeys:
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, flat, etc.):
Percentage Flat Roofing (if applicable):	%
If any flat roofing, please confirm the type (e.g. 'felt/bitumen on wood' or 'concrete flat roof'):
Construction of Floors (e.g. concrete, wood, etc.):
Fire / Intruder Alarms
Is a fire alarm installed?
Is a sprinkler system installed?
Is an intruder alarm installed?
Claims Experience
Have you or any other director or partner suffered any loss or had any claims made against the property in the last 5 years?	Yes No
Please provide details of all claims: (i.e. date of claim, amount claimed, circumstances of the claim, etc.)	Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Date of Claim: Amount Claimed:£ Details of Claim: ---------------------- Unfortunately, we will be unable to provide a quotation if you have had more than 3 claims.

Property Cover

Cover Required
Level of cover required:
Is cover required for subsidence?	Yes No
Is cover required for terrorism?	Yes No
Buildings
Buildings Sum Insured (£s):
Outbuildings Sum Insured (£s):
Buildings excess required: (Larger excess will reduce the premium)
Loss of Rent
Is cover required for loss of rent?
If yes, please confirm the current rent received per annum:	(£'s per annum)
Maximum Indemnity Period
Glass
Is cover required for external glass?	Yes No
Landlords Contents
Landlords Contents (if required) (£s):

Liability Cover

Property Owners Liability
Is cover required for Property Owners Liability?
If yes, please confirm the cover required:
Employers' Liability
Is Employers' Liability cover required? (e.g. for caretakers, gardeners, administrators, etc.)	Yes No
Please confirm the total number of employees:
Please also confirm the total wages of the employees (£s):	(£s per annum)
What type of work is carried out by the employees? (e.g. administration, property maintenance, etc.)

Additional Covers / Information

If there is any other information you wish to disclose or if you have any additional cover requirements, please provide details:

Details Of Current / Previous Policies

Current annual premium:	This may help us to get you a better quote
Current insurer:
Renewal date/date cover required:	(dd/mm/yyyy)

Request Quotation

Disclosure
Please ensure that all the information you have provided is correct and that you have answered all the questions accurately then press the Request Insurance Quotation button to send your quotation details to us.