Commercial Property Insurance

Policyholder Details

Title First Name Surname

Please enter your correspondence address:

Number Street Town

County Post Code

Home Tel Work Tel Fax No

E-Mail

How would you like to be notified of your quote?

Occupation (e.g. Accountant)

Date cover is required from

Risk Details

Please enter the details of the property to be insured:

Number Street Town

County Post Code

Year the property was built Listed Building

Number of storeys (including attic/basement)

Number of Flats/Units in whole building Number of Flat/Units to be insured

Type of Business at Premises (state all)

If vacant, how long has the property been unoccupied

If vacant, is the property to be sold

If vacant, have tenants been found

If vacant, how long is the property likely to be vacant

What percentage of the roof is flat If there is any flat roof, what construction is it

If part residential, who is the Lease Agreement with

If part residential, please provide Letting Details

If part residential, How long is the Lease Agreement

If part residential, Type of Tenant

If part residential, how many tenants are there (NB. A family is considered as 1 tenant)

Is the property of standard construction and in a good state of repair and heated solely by electricity and/or main gas

If No, please give full details

Is the property in a position/area likely to be subject to flooding or where flooding has occurred, close to a cliff, quarry or other excavation, or shows any signs of existing of previous damage by subsidence, ground heave or land slip

If Yes, please give full details

Cover

Buildings Sum Insured (the cost of rebuilding your home) (min. of £40,000)

Full Terrorism Cover required

Loss of Rent required If yes, annual rental income

Claims

Have you made any claims on this or any other property in the last 5 years

If yes, complete the form below with the most recent claims first:

	Claim 1	Claim 2	Claim 3
Date of claim
Type of claim
Please provide full details of claim (i.e. Fire, Theft, etc.)
Was claim at the property to be insured
Cost of claim (estimate if not sure)

Final Questions

Please provide the name of any Interested Party to be noted (i.e. Mortgage Company)

Have you been convicted of, or in the course of being charged with, any offence (excluding driving offences)

Have you been declared bankrupt or been a director of any company that went into liquidation

Have you had any insurance declined, cancelled, refused or had any special terms applied by any Insurer for the risks proposed

If you have answered "Yes" to any of the three questions above, please provide full details in the additional information section below.

Which search engine did you find us on

Best Quote so far

Please add any additional information that may be required for your quotation in the space below

Thank you for taking time to fill out this form. Please ensure that all required details have been completed (you will be prompted to complete the sections you have missed) and double check that your e-mail address is correct if this is your chosen method of reply or we may not be able to return your quote. Please then press the submit button below to send your details to us, wait for the confirmation page to load and you will then be contacted with your quotation as soon as it is processed.