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Painters & Decorators Public / Employers Liability Insurance Quote Form

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 Painters & Decorators Public Liability / Employers Liability Insurance only.

If you have any problems with completing this form, please phone us on 01623 641 386 for assistance.

Personal/Company Details

Proposer's Full Name(s):
(enter sole trader's name or all partner's names if a partnership)
Contact Name:
(if different to proposer's name)
Limited Company Name:
(if operating as a limited company)
Trading Name:
(if different to the above)
Trading Status:
Occupation/Trade:
Business Address:
Postcode:
Daytime Telephone Number:
Mobile Telephone Number:
*E-Mail Address:
*Please note that your email address will only be used to provide you with your quote and not for any other marketing purposes.
General Information

Have you, or any other partner or director
ever been convicted of or charged (but not yet tried)
with any criminal offences other than a motoring offence?
Yes     No
If yes, please provide details:
(e.g. type of conviction(s),
date(s) of conviction(s),
details of any fines and/or length of custodial sentence(s))
Has any insurer ever refused renewal,
declined/cancelled cover or imposed any special terms?
Yes     No
If yes, please provide details:
(e.g. details of any insurance refused/
cancelled/special terms imposed, etc.)
Have you, or any other partner or director ever had any County Court Judgements (CCJ's) / sheriff decrees / IVA's or ever been declared bankrupt, or involved in a company which has become insolvent or which has gone into liquidation, receivership or administration?Yes     No
If yes, please provide details:
(e.g. date(s) of bankruptcy/insolvency/CCJ/IVA,
amount of bankruptcy/insolvency/CCJ/IVA (£'s),
date bankruptcy discharged / date CCJ/IVA settled,
circumstances of bankruptcy/insolvency/CCJ/IVA, etc.)

Please note we are unable to provide a quote if your bankruptcy
is not discharged or your CCJ / IVA remains outstanding or unsettled.

Have you, or any other partner or director
ever been prosecuted or served a prohibition
order by the Health & Safety Executive?
Yes     No
If yes, please provide details:
(e.g. date of prosecution(s), details of offence(s), etc.)
Have you, or any other partner or director ever been the subject of a recovery action from HM Customs and Excise or the Inland Revenue?Yes     No
If yes, please provide details:
(i.e. name of person or business subject to recovery action,
date of recovery action,
and reason for the recovery action)
Trade Associations
Are you a member of a relevant
trade association for your industry?
Yes     No Help?
If yes, please provide details of
organisation and membership number:
Business Activities
Description of your work activities: help
(Please describe as fully as possible including
a percentage split between each activity,
if you carry out more than one activity)
Do you activities involve paint spraying?Yes     No
If yes, please confirm the percentage of time paint spraying:%
Work Locations
What percentage of the turnover is carried out away from your premises at the following locations:
(i) Private Dwelling Houses and Flats?%
(ii) Commercial Buildings (e.g. shops, offices, pubs, etc.)?%
(iii) Industrial Buildings (e.g. industrial units, factories, etc.)?%
(iv) Other Locations (specify below if applicable)
%
Total:100%
Is your home the base for your business or are you
operating from separate dedicated business premises?
Home  Business Premises
Is work carried out at any hazardous locations?
(e.g. offshore installations, railways, motorways, bridges, viaducts, power stations, nuclear installations, oil, gas or petrochemical refineries, aircraft/airports/airside, quarries, mines, watercraft/ships, docks, harbours, piers, towers, hospitals and other medical facilities.)
Yes     No help
If yes, please state type of location(s) and the
percentage of work spent at the location(s):
Is any work undertaken outside of the U.K.?Yes     No
If yes, please provide details:
(i.e. area, percentage of time outside UK)
Heat Use
Do your activities involve the use of heat?
(e.g. blow lamps, blow torches, welding equipment, heat guns, etc.)
Yes     No help
If yes, please state the type of heat used:
(e.g. blow lamps, blow torches, welding equipment, heat guns, etc.)
Please confirm the percentage of time it is used:
Will heat work include the
use of welding or flame cutting equipment?
Yes     No
Height Work
Please confirm the maximum height you would work: metres help
Do you or your employees use slings,
cradles, bosuns chairs or abseiling equipment?
Yes     No
If yes, please provide details:
(i.e. type of equipment and percentage
of turnover using the equipment)
Trading Experience
How many years has your business been trading? year(s)
Number of years previous experience in this trade:
(A minimum of 3 years previous experience is required if you have 0 years trading)
year(s)
Health & Safety
Do you have an up to date Health &
Safety Policy tailored to your activities?
Yes     No   Help?
Do you carry out a full Health & Safety Risk
Assessment at the contract site before commencing work?
Yes     No
Are written Method Statements prepared for each contract / job?Yes     No
Is Health & Safety training given to
employees and is the training recorded?
Yes     No
Do you supply and enforce use of
Personal Protective Equipment where required?
Yes     No
Do you work with asbestos, silica, explosives
or any other substances hazardous to health?
Yes     No
If yes, please provide details:
Claims Experience
Have you, or any other partner or director
had any claims or incidents in the last 5 years?
Yes     No
If yes, please provide details:

Details Of Cover Required

Public/Product Liability
Public/Product Liability limit of indemnity:  help
  Manual Principals Non-Manual/Clerical Principals
Number of Proprietors/Partners/Co. Directors:No. helpNo. help
Annual Wages of Proprietors/Partners/Co. Directors: 
 
 
 
Please confirm 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)
  help
Employers' Liability (Compulsory by Law if you employ direct employees or labour only sub-contractors)
Is Employers' Liability Cover Required?
(£10M standard limit of indemnity)
  help
  Manual Workers Non-Manual/Clerical Workers
No. of Employees/Labour Only Sub-Contractors: help
(Do not include proprietors, partners or directors)
No. helpNo. help
Total Annual Wages of Employees/LOSC's:
(LOSC's are Labour Only Sub Contractors)
 
 
 
 
Employers' Reference Number (optional)
Employers' Reference Number (ERN) (if available):  help
(e.g. 123/AB12345)
Turnover
Estimated annual turnover for next 12months:   
Tools Cover (Optional)
Tools Sum Insured (if required): 
£500 to £10K maximum
Legal Expenses Cover (Optional)
Is Commercial Legal Expenses cover required?
(£100,000 cover for legal disputes, employment disputes, tax investigations, etc.)
Yes     No Help?
Legal Expenses Limit of Indemnity: 
Has the business and/or its directors been
involved in any legal dispute, tax investigation
or any other court or tribunal action in the last 5 years?
Yes     No
Please provide details of the dispute including dates:
Additional Information
Details of any additional information you
wish to disclose or any other cover required:
 
You are required to make a fair presentation of the risk to insurers which means that you are required to disclose every material circumstance which you know or ought to know relating to the risk to be insured. Materially important information is any information that could influence an insurer's decision to accept your risk including the cost of your insurance. Failure to comply with the duty of fair presentation could mean that your policy is void or that insurers are not liable to pay all or part of your claim(s). By submitting this quotation you are confirming that there are no other material facts to disclose other than those shown above.
Details Of Current / Previous Policies

Cover Start Date / Renewal Date:  (dd/mm/yyyy)
Current Annual Premium / Best Quotation: 
This may help us to get you a better quote
Name of Current / Previous Insurer: 
e.g. Aviva, AXA, Allianz, QBE, RSA, Zurich, etc.

Request Quotation

Disclosure
Please ensure that all the information you have provided is correct, then press the 'Request Painters & Decorators Liability Insurance Quote' button and we will contact you shortly with a quotation.


Estimated Quote Time: 1 to 72 hours