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Online Quote
 
 

Quote Type:
 
Client Name:
Company Name:
Started Trading:
Risk Address:
 
 
Post Code:
   

Correspondent Address (If Different):
Post Code:
   
Contact Number:
Fax:
Email:
   
Business Description:
   
Property Type:
   
Does the client:
Is the property
Is the property of Standard Construction:
Yes No
   
Number of Employees
Manual: Turnover: £
Clerical: Wage roll: £
Employers Liability:
Yes No
   
Sums Insured Required
Buildings: £ or Tenants Improvements: £
General Contents: £ Stock: £
Fixtures & Fittings: £ Public Liability:
       
Premises Security
Alarm:
Yes No
If Yes, Make, Maintained By & Policy Response:
Shutters:
Yes No
Bars on Accessible Windows:
Yes No
Mortise Dead Locks:
Yes No
   
Current Insurers:
Premium:
   
Any Previous Claims:
Yes No
If Yes, Date, Reason, Claim Amount::
   
Additional Information: