Quote4Insurance
Manufacturing & Repairs
Section 1 - Personal Details
Address
Town
City
County
Postcode
Email
Telephone Number
Fax Number
Best Time to Call
Section 2 - Address for Correspondence
Title
Mr.
Mrs.
Miss
Dr.
Rev.
First Names
Surname
Address
Town
City
County
Postcode
Telephone
Email
Target Premium
Quotation Required By
Claims details of last 5 years
Section 3 - Trade/ Profession
Type
(Please give full details of processes involved & products supplied)
Imports & Exports
Single/ Multi Tenure Premises
If Multi Tenure, please provide details of other tenants' business
When was Business Est.
How long in business in this premises
Standard Construction:
Yes
No
-- Select --
Security Alarm?
Yes
No
-- Select --
NACOSS Approved?
Yes
No
-- Select --
If YES - Type of signalling (i.e Bell only, Digi Comm, Redcare)
Will Proposer fit/upgrade security?
Yes
No
-- Select --
Section 4 - Sums Insured
Buildings
Portable Electrial Equipment
Nonferrous Metals e.g Aluminium, Copper, etc
Wines & Spirits
Contents (fix/fits/machinery & plant)
Yes
No
-- Select --
Sum Insured
Computer Equipment
Accidental Damage (Optional)
Business Interruption
Turnover
Goods in Transit - Limit
'All Risk Items'
Any use of heating, welding or flame cutting equipment away from your premises?
Yes
No
-- Select --
Other heat used away from premises?
Yes
No
-- Select --
Section 5 - Liabilities
Directors & Employees Clerical Wages
Directors & Employees Manual Wages
Directors & Employees Manual Wages whilst working away
Legal Expenses
Yes
No
-- Select --
Contact Disputes
Yes
No
-- Select --
Additional Information
How did you hear of
Quote4insurance
?
e.g. Name of magazine/newspaper you saw our advert in, T.V., radio, Teletext,diverted from other site = please name site / search engine, internet advert etc.