For UK Customers Only

Please insert your details below and one of our commercial advisers will contact you shortly with a liability insurance quotation.

This form is designed for quotes for Public/Employers Liability Insurance for electricians/electrical contractors only. If you require cover for any other type of commercial insurance, please return to our business insurance page. Please note that we are unable to quote for risks based in Ireland.

If you have any problems with completing this form, please phone us on 08453 455 855 for assistance.

Personal/Company Details
Proposers Name (incl. partners names if partnership):
Occupation/Trade:
Trading Name:
Trading Status:	- - - - - - Please Select - - - - - Sole Proprietor Partnership Limited Company Unincorporated Association
Postal Address:
Postcode:
Daytime Telephone Number:
E-Mail Address:
General Information
Description of your business activities: (Please describe as fully as possible)
Is your home the base for your business or are you operating from seperate dedicated business premises?	- - Please Select - - Home Business Premises
Is any work undertaken outside of the U.K.?	Please Select Yes No
Do your activities involve the use of heat?	Please Select Yes No
If yes, please state the type of heat used (e.g. blowlamp) and how frequently it is used:	Type Used: Frequency:
Do you carry our any 3 phase work?	Please Select Yes No
How many years has your business been trading?	Please Select 0 Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11+ Years
Number of years experience (if different)	Please Select 0 Years 1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11+ Years
Have you or any other partner or director suffered any loss or had any claims made against you in the last 5 years?	Please Select Yes No
If yes, please provide details:	Date of claim: Cost of claim:£ Details of claim: ---------------------------- Date of claim: Cost of claim:£ Details of claim: ---------------------------- Regrettably, if you have more than 2 claims, we will be unable to provide you with a quotation.

Details Of Liability Cover Required
Public/Product Liability
Public/Product Liability limit of indemnity:	£	1 Million 2 Million 5 Million Not Required
Number of Proprietors/Partners/Co. Directors:
Wages of Proprietors/Partners/Co. Directors:	£
Annual Turnover:	£
Please state your annual payments to bona-fide sub-contractors (if used): (BFSC's are sub-contractors who supply their own materials on site and hold their own insurance)	£
Employers Liability (Compulsory by Law if you employ staff)
Is Employers Liability Cover Required?		Please Select Yes No
Number of Clerical/Administrative Employees:		Do not include proprietors, partners or directors
Number of Manual Working Employees:		Do not include proprietors, partners or directors
Total Annual Wages of Employees:	£
Tools Cover (Optional)
Tools Sum Insured:	£	(£2,500 max sum insured)
Additional Information
Any additional information / cover required:
Van Renewal Date (optional):		(dd/mm/yyyy)

Details Of Current / Previous Policies
Current Annual Premium:	£	This may help us to get you a better quote
Current/Previous Insurer:
Renewal Date (if applicable):		(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 Liability Quotation button and we will contact you shortly with a quotation.