Personal/Company Details
Proposers Name (incl. partners names if partnership):
Occupation:
Trading Name:
Trading Status:
Please Select
Sole Trader
Partnership
Ltd. Company
Trading Address:
Postcode:
Telephone Number:
E-Mail Address:
General Information
Description of your security activities:(Please describe as fully as possible)
How many years has your business been trading?
Number of years experience (if different) :
If you are a new company, please give details of experience:
Please give details of any trade association or regulatory body you are a member of:
Please state the percentage split of your contracts:
Offices: %
Warehouses & Factories: %
Shopping Precincts: %
Buildings Sites: %
Garages/Car Compounds: %
Other Work (please specify) : %
Total: 100%
Do you undertake any work outside England, Scotland, Wales the Channel Islands or the Isle of Man?
Please Select
No
Yes
Guard Dogs
If guard dogs are used, please state the number of guard dogs used:
Screening Procedures
If you have employees, are satisfactory screening procedures in place for all employees?(i.e. written references going back to a period of at least 10 years or to school age)
Please Select
No
Yes
N/A
General Information
Have you had any previous security insurance declined, cancelled or refused to be renewed by an insurer?
Please Select
No
Yes
Have you or any director or partner ever been declared bankrupt or insolvent?
Please Select
No
Yes
Have you or any director or partner ever been convicted of or charged (but not yet tried) or been given an Official Police Caution in respect of any criminal offence other than a motoring offence?
Please Select
No
Yes
Claims Information
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
No
Yes
If yes, please provide details:(i.e. date of claim, amount claimed, circumstances of claim, etc.)