Plumbers Public Liability Insurance Quote Form

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 Plumbers Public Liability Insurance / 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:	- - - - - - Please Select - - - - - Sole Trader Partnership Limited Company Limited Liability Partnership Unincorporated Association
Occupation/Trade:
Business Address:
Postcode:
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
General Details
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/reason for conviction(s), date(s) of conviction(s), details of any fines and/or community service (if applicable), length of custodial sentence(s) (if applicable),etc.)
Has any insurer ever refused renewal, declined or cancelled cover or imposed any special terms?	Yes     No
If yes, please provide details: (e.g. details/reason for 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.)
Business Activities
Description of your work activities: (Please describe as fully as possible including a percentage split between each activity, if you carry out more than one activity)
Does your work involve the connection of gas?	Yes     No
Does your work involve the installation of central heating systems?	Yes     No
Do any contracts involve the installation, servicing, replacement, repair, upgrade, extension or control of any central heating system with a capacity in excess of 70kW?	Yes     No
If yes, please provide details:
Work Locations
What percentage of the turnover is carried out 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
Hazardous Locations
Is work carried out at any hazardous locations? (e.g. railways, motorways, bridges, viaducts, nuclear installations, power stations, refineries, airports, quarries, mines, ships, docks, piers, towers, offshore installations, etc.)	Yes     No
Please confirm percentage of work at the location(s) the type of work carried out, and the type of hazardous location(s) worked at:
Work Outside of UK
Is any work undertaken outside of the U.K.?	Yes     No
If yes, please provide details: (i.e. country / region worked at, percentage of turnover this work represents and type of work carried out.)
Professional Services
Do you provide professional services for a fee such as advice/consultancy, design, testing, inspection and certification?	Yes     No
Heat Use
Do your activities involve the use of heat? (e.g. blow lamps, blow torches, welding equipment, heat guns, etc.)	Yes     No
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:	0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%
Will heat work include the use of welding or flame cutting equipment?	Yes     No
Height Work
Please confirm the maximum height you would work:	0 5 8 10 12 15 20 30 30+ metres
Years Trading / Experience
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 12 Years 13 Years 14 Years 15 Years 16 Years 17 Years 18 Years 19 Years 20 Years 21 Years 22 Years 23 Years 24 Years 25 Years 26 Years 27 Years 28 Years 29 Years 30 Years 30+ Years
Number of years previous experience in this trade: (A minimum of 3 years previous experience is required if you have 0 years 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 12 Years 13 Years 14 Years 15 Years 16 Years 17 Years 18 Years 19 Years 20 Years 21 Years 22 Years 23 Years 24 Years 25 Years 26 Years 27 Years 28 Years 29 Years 30 Years 30+ Years
Claims Experience
Have you, or any other partner or director suffered any loss or had any claims made against you in the last 5 years?	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 Cover Required
Public/Product Liability
Public/Product Liability limit of indemnity:		£1 Million £2 Million £5 Million £10 Million Not Required
		Manual Principals		Non-Manual/ Clerical Principals
No. of Proprietors/Partners/Co. Directors:	No.		No.
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)
Employers' Liability (Compulsory by Law if you have employees or use labour only sub-contractors)
Is Employers' Liability Cover Required? (£10M standard limit of indemnity)		Please Select Yes No
		Manual Employees		Non-Manual/ Clerical Employees
No. of Employees/Labour Only Sub-Contractors: (Do not include proprietors, partners or directors)	No.		No.
Annual Wages of Employees/Labour Only Sub-Contractors:
Annual Turnover
Estimated annual turnover for forthcoming 12 months:
Optional Cover(s)
Tools Cover (Optional)
Tools Sum Insured (if required):		£0 £500 £1,000 £1,500 £2,000 £2,500 £3,000 £3,500 £4,000 £4,500 £5,000
Professional Indemnity Cover (Optional)
Is Professional Indemnity Cover required?		Yes     No
If yes, please state limit of indemnity required:		Please Select £100,000 £250,000 £500,000 £1,000,000 £2,000,000 £5,000,000
Does more than 25% of your turnover relate to design, advice, surveying, or consultancy carried out for a fee?		Yes     No
Is any work undertaken outside of the European Economic Area?		Yes     No
Have you had any claims or incidents that could give rise to a claim in the last 5 years?		Yes     No
If yes, please provide details: (e.g. dates of claims, amount paid, circumstances leading to the claims, etc.)
Legal Expenses Cover (Optional)
Is Commercial Legal Expenses cover required? (£100,000 cover for legal disputes, employment disputes, tax investigations, etc.)		Yes     No
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 that 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 Plumbers Liability Quote button and we will contact you shortly with a quotation.

Estimated Quote Time: 1 to 3 working days