Commercial Combined Quotation form

Insured or company name:


Company status:


Risk Address:

House Number:


Street:


Town:


County:


Postcode:


Occupation:


Business:


Business Established:


Date of cover


In Order to Calculate the Premium we will require the following Information about your company. If this is a new venture or you have not been trading for a full year, please estimate the figures requested from your company projections or your business plan. If you are unsure please contact one of our specialists today 0800 021 4504:





Buildings Cover Required


Sum insured


Is Subsidence Cover Required


Trade Contents


Stock


Computor / Office Contents


Tenants Inmprovements


Turnover of the Company



Money:

In a locked safe when closed for business:


Not in safe when closed for business :


Any Other Loss :



Employers Liability

Annual Clerical Wage Roll:


Annual Manual Wages on own premises:


Annual Manual Wages away from own premises:



PUBLIC/PRODUCTS LIABILITY:


Estimate: Annual Turnover For Manual Work -


- away from the Insured Premises:



Goods in transit

Limit per own vehicle:


Professional Carriers Limit:



Your Premises

SECURITY: Burglar Alarm:


Is it....:


FIRE: Alarm:


FIRE: Sprinklers:


Method of heating:



Health and Safety

Do you have a written Health & Safety Policy in Place:


When was this Last reviewed:


Do You Provide Staff Inductions and Training:


Is this recorded:


Do You carry out Health and Safety Risk Assessments for staff:



Claims

Have you have any Claims in the Last 5 Years:


Date of claim:


Type of claim:


Approx amount claimed:






Stage
Stage 1
Final Stage