Roofers Public Liability Insurance Quote Form

For UK Customers Only

Please insert your details here and one of our commercial advisers will contact you shortly with a roofers liability insurance quote.

This form is designed for quotes for Roofers and Roofing Contractors Public Liability Insurance quotes only. Cover can be extended to include employers liability insurance if you have employees or use labour only sub-contractors.

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:
Business Address:
Business Postcode:
Daytime 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. date of any insurance refused/ cancelled/special terms imposed, reason for insurance refused/cancelled, 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, amount of bankruptcy/insolvency, date bankruptcy discharged or CCJ/IVA settled, circumstances of bankruptcy/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 or improvement 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)
Description of Work Activities
Full description of work undertaken: (Please describe as fully as possible including a percentage split between each activity where you carry out more than one activity)
Does any of your work involve wall/roof cladding?	Yes No
If yes, please confirm percentage cladding work: (e.g. 10%)
Do you only use fire retardant cladding?	Yes No
Do you use any ACM/ACP cladding materials?	Yes No
Do you undertake any work in connection with multi-storey buildings?	Yes No
If yes, please confirm the maximum number of storeys of buildings worked on:
If yes, please confirm the type of multi-storey properties worked on: (e.g. houses, office blocks, blocks of flats, etc.)
Type of Premises Worked On (Must add up to 100%)
Please state the percentage split of work carried out away from your premises at the following locations:
Private Dwelling Houses (PDH's) and flats?	%
Commercial buildings (e.g. shops, offices, etc.)?	%
Schools / Leisure Centres / Hospitals / Local Authority Buildings?	%
Industrial buildings (e.g. industrial units, factories, etc.)?	%
All other premises (state below if applicable)?	%
Total:	100%
Percentage of Work on 'New Builds' (if applicable)
What percentage of the above work is on 'New Builds' (if applicable): (e.g. percentage work on new build houses, blocks of flats, etc., if applicable)	%
Hazardous Locations / Work Outside of UK
Is work carried out at any hazardous locations? (Hazardous locations can include, but are not limited to; railways, motorways, towers, steeples, spires, bridges, viaducts, nuclear installations, refineries, airports, quarries, mines, ships, docks, piers and offshore installations.)	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 of the U.K.?	Yes No
If yes, please provide details: (i.e. area/country of work, percentage of work outside UK)
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)
Work at Height Activities
Please state the maximum height worked:	metres
Please confirm the approx. percentage of time working at the following heights:
Up to 10 metres:	%
Up to 15 metres:	%
Up to 20 metres:	%
Over 20 metres:	%
Total:	100%
If any work is above 15 metres, please provide details: (e.g. type(s) of buildings worked on / work undertaken, and percentage of turnover that this work represents)
Do your activities involve the use of slings, cradles, bosuns chairs, abseiling or similar equipment other than for equipment designed for the raising, lowering or transporatation of inanimate materials?	Yes No
Please provide details of equipment used and the percentage use of this equipment:
Do you use hydraulic platforms, cherry pickers, access plant or other equipment?	Yes No
Please provide details of equipment used and the percentage of use of this equipment: (e.g. 10% use of cherry pickers, etc.)
Scaffolding
Do you use a scaffolding sub-contractor?	Yes No
Do you ever erect your own scaffolding?	Yes No
If yes, type of scaffolding (e.g. tower, tied, etc.):
How often do you erect your own scaffolding?
What is the maximum height of the scaffolding you erect for your own use?	metre(s)
Heat Use
Do your activities involve the use of heat? (e.g. hot air guns, blow lamps/torches, tar/bitumen/asphalt heaters, welders, grinders, etc.)	Yes No
Please confirm the total percentage use of heat?
If yes, please confirm all types of heat used and percentage of heat used: (e.g. 4% hot air guns, 3% blow lamp, 3% tar/bitumen/asphalt heaters, etc.)
Trade Associations
Is your company a member of the NFRC or any other relevant trade association? (discounts may be available if you are member of a trade association)	Yes No
If yes, please provide details of trade association(s):
Health & Safety
Do you have a written Health & Safety policy in force?	Yes No
Do you carry out Risk Assessments at the contract site before commencing work?	Yes No
Are written Method Statements prepared for each 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 (PPE) where required?	Yes No
Asbestos / Hazardous Materials
Do you work with asbestos, silica or any other materials hazardous to health?	Yes No
Please provide details of all hazardous materials: (e.g. non-notifiable asbestos, notifiable asbestos, silica, etc.)
What percentage of your work involves working with hazardous materials (e.g. 10%)?	%
Claims History
In relation to this business or any other previous business in which the proprietor or any partners or directors have traded, in this or any other name, has there been a claim under any of the cover(s) within the last 5 years?	Yes No
If yes, please provide details:	Date of claim 1: Cost of claim 1:£ How claim occurred? Has the claim been paid/settled? ----- Date of claim 2: Cost of claim 2:£ How claim occurred? Has the claim been paid/settled? ----- Unfortunately, we are unable to provide a quotation if you are exceeding 2 claims. -----

Details Of Liability Cover Required

Public/Product Liability
Public/Product Liability limit of indemnity required:
		Manual Principals		Non-Manual / Clerical Principals
Number of Proprietors/Partners/Company Directors:	No.		No.
Annual Wages of Proprietors/Partners/Co. Directors:
Annual Payments to Bona Fide Sub-Contractors (if used): (BFSC's are sub-contractors who supply their own equipment / materials on site and hold their own liability insurance (e.g. scaffolders, etc.))
Estimated Annual Turnover
Estimated Annual Turnover for the next 12 months: (Please be as accurate as possible, as an over estimation will increase the premium to be quoted)
Percentage Split of Turnover (Must add up to 100%)
In respect of the total turnover above, please confirm the percentage split in respect of the following:
(i) Slating and tiling contracts:		%
(ii) Mastic asphalt, flat and felt roofing contracts:		%
(iii) Industrial sheeting and cladding contracts:		%
(iv) All other roofing contracts:		%
(v) All other (non-roofing) contracts (please state details of all other work below if applicable)		%
Total:		100%

Employers Liability (Compulsory by Law if you employ direct employees or use labour only sub-contractors)
Is Employers Liability required? (£10M standard limit of indemnity)		Yes No
		Manual Workers		Non-Manual / Clerical Workers
Total No. of Employees/Labour Only Sub-Contractors: (Do not include proprietors, partners and directors)	No.		No.
Annual Wages of Employees working at own premises:
Split of Annual Wages of Employees Working Away on Site
Annual Wages of Employees working away at ground level:
Annual Wages of Employees working away and at height:
Annual Wages of Supervisors (working at ground level):
Annual Payments to Labour Only Sub-Contractors: (LOSC's are sub-contractors who supply only labour and not materials)
CSCS Cards
Do all your relevant employees and Labour Only Sub Contractors have current CSCS cards?		Yes No
Employers' Reference Number (optional)
Employers' Reference Number (ERN) (if available):		(e.g. 123/AB12345 or 'Exempt')

Additional Optional Covers

Professional Indemnity (optional)
Is Professional Indemnity cover required? (Recommended if you provide any advice, design or specification)		Yes No
Limit of indemnity required:
Does more than 10% of your turnover relate to pure advice, design, specification, surveying, or consultation carried out for a fee?		Yes No
If yes, please confirm percentage of turnover?
Have you, or your company previously held professional indemnity insurance?		Yes No
If yes, do you currently have a retroactive date for your current policy?		Yes No
If yes, please provide the retroactive date of your current policy:
Are you aware of any circumstances or incidents in the last 6 years that could give rise to a professional indemnity claim being made against you?		Yes No
If yes, please provide details:		Date of incident 1: Circumstances of incident? Has the claim been paid/settled? If yes, how much? £ ----- Date of incident 2: Circumstances of incident? Has the claim been paid/settled? If yes, how much? £ ----- Unfortunately, we are unable to provide a quotation if you are exceeding 2 incidents/claims. -----
Directors & Officers Cover (optional)
Is Directors and Officers cover required? (Cover for any 'wrongful act' of a director of a limited company)		Yes No
Please confirm the limit of indemnity required:
Can you confirm that the company is domiciled in the UK; is privately held; has not raised any funds from external parties; has been in operation for more than 12 months; has its financial statements prepared by a qualified accountant, shows a profit and are not subject to any concerns by the auditors; derives at least 50% of all its turnover from clients within the UK and EU; has not acquired any companies which have increased its total assets by 50% or more; and has no mergers or acquisitions planned and has not had any claims made against it or its directors and is not aware of any circumstances that could give rise to such claim?		Yes No
If no, details:
Contract Works (optional)
Do you require cover for Contract Works? (i.e. the permanent / temporary works and materials on site)		Yes No
Please state the maximum value of any one contract: (This amount will normally be less than and no more than your annual turnover.)
Please state the maximum length of any one contract: (e.g. typically up to a maximum of 6 or 12 months)
Own Plant (optional)
Do you require cover for Own Plant & Equipment? (e.g. scaffolding, conveyor belts, generators, cements mixers, access plant, etc.)		Yes No
Please confirm the Total Value of your Own Plant, Tools & Equipment required to be covered whilst working on site:
Please confirm the Maximum Value of Any One Item of your own plant:
Hired-In Plant (optional)
Do you require cover for Hired-In Plant? (e.g. cherry pickers, mobile elevated working platforms (MEWPS), mobile cranes, etc.)		Yes No
Please confirm the hired-in plant total limit of indemnity for all items of hired-in plant:
Please confirm the maximum limit of indemnity for any one item of hired-in plant:
Your estimated annual hiring charges/costs incurred: (e.g. £5,000 per annum)		per annum
Business Legal Expenses Cover (optional)
Is Business Legal Expenses cover required? (£100,000 standard limit of indemnity)		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(s) including date(s):

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:
Current Renewal Premium / Best Quote:		This may help us to get you a better quote
Name of Current / Previous Insurer:		e.g. ECIC, IIGL, Kerry London (KL), Pen Underwriting, etc.

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 Roofers Liability Quote button and we will contact you shortly with a quotation.

Estimated Quote Time: 1 to 4 working days