General Information
Please state the number of years trading under current management:
0
1
2
3
4
5
6
7
8
9
10
11+
If a new venture, please state the number of years previous experience (if applicable) :
0
1
2
3
4
5
6
7
8
9
10
11+
Construction of Walls (e.g. brick, stone, etc.) :
Construction of Roof (e.g. tile, slate, felt, 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.) :
Approximately, what year was the property built?
Is the property a listed building (i.e. grade I, II, etc.)
Please Select
Not Listed
Grade I
Grade II
Grade II*
Please state the distance to the nearest water(e.g. river, canal, lake, coast, etc.) :
Has the property ever suffered from subsidence or flood damage?
Please Select
No
Yes
If yes, please provide details:(i.e. date of damage, amount of damage, type of damage, etc.)
Entertainment
Do you have a late licence/extended opening hours?
Please Select
No
Yes
If yes, please provide details:
Do you employ doormen?
Please Select
No
Yes
Is there any live entertainment at the premises?
Please Select
No
Yes
If yes, state the type of entertainment (e.g. disco, bands, etc.) , how many times per week the entertainment is held and whether an entry fee is charged at the door:
Is there a dance floor?
Please Select
No
Yes
If yes, please state the maximum capacity of people on the dance floor area:
Are there any childrens play area's?
Please Select
No
Yes
If yes, please state the type of play equipment and the type of floor covering(e.g. bark chippings, cork, grass, etc.) :
Security
Is the pub occupied by the landlord/manager overnight?
Please Select
No
Yes
Are all your external doors fitted with a minimum of 5 lever mortise deadlocks which comply with BS3621(look for the British Standard Kitemark) ?
Please Select
No
Yes
Are all opening windows fitted with key operated window locks?
Please Select
No
Yes
Is the pub protected by an intruder alarm?
Please Select
No
Yes
If yes, is the alarm N.A.C.O.S.S. approved?
Please Select
No
Yes
Not Sure
Type of intruder alarm fitted:
- - - - - - Please Select - - - - - -
Audible - Bells or Siren
Monitored - Central Station
Dialler - To Principals House
REDCARE - To Police
Are your premises situated within a street level Local Authority Council CCTV area?
Please Select
No
Yes
Please provide details of any other security arrangements:(e.g. shutters, window grilles, etc.)
Claims History/Experience
Have you or any other director or partner (in this or any other trading name) suffered any loss or had any claims made against you in the last 5 years?
Please Select
No
Yes
If yes, please provide details:(i.e. date of claim, description of claim, amount claimed, etc.)
Cooking/Accomodation
Is any cooking carried out at the premises?
Please Select
No
Yes
If yes, please confirm whether or not you provide bar meals only or have a seperate restaurant:
- - - - - - Please Select - - - - - -
Bar Meals Only
Restaurant Area Only
Bar Meals + Restaurant Area
Not Applicable
Do you carry out Deep Fat Frying?
Please Select
No
Yes
If yes, please state type of frying equipment:
- - Please Select - -
Full Frying Range
Freestanding Fryer
Table Top Fryer
Do you provide accomodation?
Please Select
No
Yes
If yes, please indicate the total number of guest rooms:
Please state the maximum number of guests(if applicable) :
Type of guests staying (if applicable)
- - Please Select - -
Overnight Only
D.S.S.
Bed and Breakfast
Other
Total guests effects sum insured (if required)
Contents / Cover
Level of Cover Required?
- - - - Please Choose - - - -
Fire & Theft Cover
Fire, Theft & Accidental
Fixed External Glass Sum Insured:
Money Sum Insured (£2,000 std. cover) :
Goods In Transit Sum Insured (if required) :
Electronic Equipment Sum Insured (e.g. tills, etc.) :
All Other Pub Fixtures & Fittings/Contents Sum Insured:
Personal/Houseshold Contents Sum Insured(if required and you live at the property) :
Stock
Wines and Spirits (excluding beer) :
Tobacco, Cigarettes & Cigars:
Frozen Food Sum Insured (if required) :
Age of Refrigeration Units (if applicable) :
All Other Stock Sum Insured:
Buildings (if applicable)
Buildings Sum Insured including outbuildings, rebuilding architects' fees, removal of debris, etc:
Do you require subsidence cover for your buildings? Yes No
Business Interruption
Do you require business interruption cover?(i.e. loss of revenue following an insured event)
Please Select
No
Yes
If yes, please state the Gross Profit of your business (£'s):
Please state the period of time you wish the cover to extend?(allow sufficient time for rebuilding/refurbishing and further time to resume normal trading) 12 months 24 months 36 months
Do you require cover for loss of liquor licence(i.e. depreciation of the value of the premises) ?
Please Select
No
Yes
If yes, please state the sum insured required (£'s):
If loss of licence cover is required, state the date the licence was obtained:
Do you require cover for loss of Book Debts?
Please Select
No
Yes
If yes, please indicate the maximum amount of Gross Fees and Debit Balances outstanding at any one time (£'s):
Public/Employers Liability Cover
Public / Product Liability limit of indemnity:
£1,000,000
£2,000,000
£5,000,000
Please state the Turnover of your business (£'s):
Do you require Employers Liability cover?(£10 Million limit of indemnity)
Please Select
No
Yes
If yes, please state the total number of employee's:
If yes, please state the total wages of the employee's (£'s): Per Annum