Contractors All Risks Quotation Form

For UK Customers Only

Please insert your details here and one of our commercial advisers will contact you with a contractors all risks insurance quotation shortly.

This form is designed to for individuals/companies requiring contractors all risks insurance whilst working at a contract site. The policy can provide cover for public & employers liability, contract works, own plant, hired-in plant, employees tools and temporary buildings.

If you have any problems with completing this form, please phone us on 01623 641 386 for assistance. Regrettably, we are unable to quote for risks based in Ireland.

General Contact Information

Proposers Name(s): (incl. all partners names if partnership)
Limited Company Name: (if applicable)
Trading Name:
Trading Status:
Trading Address:
Postcode:
Daytime Telephone Number:
Mobile Telephone Number:
E-Mail Address:

General Information

Have you, or any other partner or director ever been convicted of any offences, been declared bankrupt/insolvent or had any insurance refused or cancelled?	Yes No
If yes, please provide details:

Trade / Work Undertaken
Description of your business activities: (Please describe as fully as possible)
Please state all types of properties worked on: (e.g. private dwelling houses, shops, offices, factories, etc.)
Hazardous Locations / Work Outside UK
Is work carried out at any hazardous locations?	Yes No
If yes, please state type of location(s) and the percentage of work spent at the location(s):
Is any work undertaken outside the UK?	Yes No
If yes, please provide details:
Trading Experience
How many years has the business been trading?	years
Number of years experience (if different)	years
Depth / Height Work
Please state maximum depth worked:	metres
Please state maximum height worked:	metres
Heat Details
Do your activities involve the use of heat?	Yes No
If yes, please state the type used and the percentage of work that involves the use of heat:	Type used: Percentage of work:
Health & Safety
Have you, or any other Partner or Director ever been prosecuted under the Health & Safety at Work Act?	Yes No
If yes, please provide details:
Do you have an up to date Health & Safety Policy tailored to your activities?	Yes No
Do you carry out a full Health & Safety Risk Assessment at the contract site before commencing work?	Yes No
Do you work with asbestos, silica, explosives or any other substances hazardous to health?	Yes No
If yes, please provide details:
Security Details
Do you erect full site perimeter fencing and/or boarding at the contract site?	Yes No
Please provide details of any additional security used to secure any materials or plant on site: (e.g. security patrols, plant kept in locked building, etc.)
Claims History
Has there been any claims in the last 5 years?	Yes No
If yes, please provide details:	Date of claim 1: Cost of claim 1:£ How claim occurred? ----- Date of claim 2: Cost of claim 2:£ How claim occurred? ----- Date of claim 3: Cost of claim 3:£ How claim occurred? ----- Unfortunately, we are unable to provide a quotation if you are exceeding 3 claims. -----
Turnover
Estimated turnover for the next 12 months (£'s): (Please be as accurate as possible, as an over estimation will increase the premium to be quoted)
Builders Only
If your trade or business is builder, please state the percentage split of your work:
New Construction up to 20m height:	%
New Construction up to 10m height:	%
General Building: (alteration, maintenance, repairs, etc.)	%
Other Building Work (please describe)	%
Total:	100%

Details of Cover Required

Public/Product Liability Cover
Is Public/Product Liability required?
Limit of Indemnity required:
	Manual Principals	Non-Manual/Clerical Principals
Number of Proprietors/Partners/Company Directors:
Wages of Proprietors/Partners/Company Directors (£'s):
Annual payments to Bona- Fide Sub-Contractors if used (£'s): (BFSC's are sub-contractors who supply their own materials on site and hold their own insurance)
Employers' Liability Cover
Is Employers' Liability required?
	Manual Workers	Non-Manual/Clerical Workers
No. of Employees/Labour Only Subcontractors: (Do not include proprietors, partners and directors)
Annual Wages of Employees/Labour Only Subcontractors (£'s):
Contract Works
Do you require cover for Contract Works?	Yes No
Please state the maximum value of any one contract (£'s):
Please state the maximum length of any one contract (e.g. 6 months, etc.):
Own Plant
Do you require cover for Own Plant?	Yes No
Please state the total value of your Own Plant, Tools & Equipment required to be covered whilst working on site (£'s):
Hired-In Plant
Do you require cover for Hired-In Plant?	Yes No
Please state annual charges/costs incurred (£'s):
Please state the maximum value of any one item of hired-in plant (£'s):
Employees' Tools
Do you require cover for Employees' Tools?	Yes No
Please state how much cover you require for your Employee's Tools (£'s):
Site Huts / Temporary Buildings
Do you require cover for Site Huts / Temporary Buildings?	Yes No
Please state how much cover you require for site huts / temporary buildings (£'s):
Additional Information / Cover
Details of any additional information / cover:

Details Of Current / Previous Policies

Current annual premium:	This may help us to get you a better quote
Current / previous insurer:
Renewal date / date cover required:

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 Contractors Quotation button and we will contact you shortly with a quotation.

Estimated Quote Time: 0 - 2 working days