Proposers Details
Owner(s) Of The Property
Proposers Name(s) (incl. partners names if partnership):
Company Name (if applicable) :
Ownership Status:
- Please Select -
Sole Owner
Partnership
Ltd. Company
Association
Charity
Club
Proposers correspondence Address:
Postcode:
Daytime Telephone No.
E-Mail Address:
Proposers History
Has any insurer ever refused, declined, cancelled or imposed special terms? Yes No
Have you or any partner or director ever been convicted of or charged with any criminal offence? Yes No
Have you or any partner or director ever been declared bankrupt or insolvent? Yes No
Number of years operating as a property owner?
0
1
2
3
4
5
6
7
8
9
10
11+
Do you operate a business from these premises?
Please Select
No
Yes
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, etc.)
Please Select
Not Listed
Grade I
Grade II
Grade II*
Grade A
Grade B
Grade C
Has the property ever suffered from subsidence or flood damage?
Please Select
No
Yes
If yes, please provide details:(e.g. date of damage, amount of damage, etc.)
Occupancy Details
Is there any accomodation above the business premises (e.g. flat, etc.)?
Please Select
No
Yes
If yes, state tenancy type:
- - - - - - - Please Select - - - - - - -
Assylum Seekers
DSS Tenants
Professional Working Tenants
Proposer Living At Premises
Student Tenants
Unnocupied
Are any of the area's of the building unoccupied?
Please Select
No
Yes
If yes, what percentage is unoccupied? %
If unoccupied, which floor is unoccupied and how long has it been unoccupied?
If 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?
Please Select
No
Yes
Construction
Property details:
- Please Select -
Detached
Semi-Detached
Terraced (Mid)
Terraced (End)
Number of storeys:
0
1
2
3
4
5
6
7
8
9
10
11
12
12+
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 state 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?
- - - - - - - - - - Please Select - - - - - - - - - -
No Fire Alarm
Yes-Bells/Audible Only Fire Alarm
Yes-Bells + Central Station Monitored
Is a sprinkler system installed?
- - - - - - Please Select - - - - - -
No Sprinklers
Yes-Specification Unknown
Yes-28th Edition
Yes-29th Edition
Yes-BS 5306
Yes-BS EN 12845
Is an intruder alarm installed?
- - - - - - - - - - - - - - - - Please Select - - - - - - - - - - - - - - - - -
No Intruder Alarm
Yes-Bells/Audible Only Alarm
Yes-Digital Communicator To Principals House
Yes-Digital Communicator To Alarm Receiving Centre
Yes-Dual-Comm/Paknet To Alarm Receiving Centre
Yes-RedCare To Alarm Receiving Centre
Yes-RedCare GSM To Alarm Receiving Centre
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?
Please Select
No
Yes
If yes, please provide details:(i.e. date of claim, amount claimed, circumstances of the claim, etc.)
Property Cover
Cover Required
Level of cover required:
Please Select
Standard Perils
Commercial All Risks
Is cover required for subsidence?
Please Select
No
Yes
Is cover required for terrorism?
Please Select
No
Yes
Buildings
Buildings Sum Insured (£'s):
Outbuildings Sum Insured (£'s):
Buildings excess required:(Larger excess will reduce the premium)
£100
£250
£500
£1,000
£5,000
Loss of Rent
Is cover required for loss of rent?
Please Select
No
Yes
If yes, please state the current rent receivable (£'s): (£'s per annum)
Glass
Is cover required for external glass?
Please Select
No
Yes
Landlords Contents
Landlords Contents (if required) (£'s):
Liability Cover
Property Owners Liability
Is cover required for Property Owners Liability?
Please Select
No
Yes
If yes, please state the cover required:
£0
£1 Million
£2 Million
£5 Million
Employers' Liability
Is Employers' Liability cover required?(e.g. for caretakers, gardeners, administrators, etc.)
Please Select
No
Yes
If yes, please state the total number of employee's:
If yes, please also state the total wages of the employee's (£'s): (£'s per annum)
What type of work is carried out by the employees?(e.g. administration, property maintenance, etc.)
Additional Covers
If there is any other type of cover that you wish to include, please provide details: