Liability Enquiry

TRADESMAN AND PROFESSIONALS ASSUMPTIONS.We have made the following assumptions when preparing this quote. Please READ THEM CAREFULLY. ONLY CLICK THE CHECK BOX BELOW if you can agree with all assumptions. These assumptions, together with any other information you provide, will form the basis of the contract between the insurer and you. If you agree to a statement that is untrue or inaccurate in any way, the policy may not protect you in the event of a claim. Assumptions You must agree that your work does not involve any discharge of fumes, effluent or anything of a noxious nature. Finally, you must agree that not you, a director or partner of the Business, or its Subsidiary Companies, has ever either personally or in any business capacity: • had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or has any prosecutions pending • been declared bankrupt or insolvent or been the subject of bankruptcy proceedings or insolvency proceedings • had a proposal refused or declined • had an insurance cancelled or renewal refused • had special terms imposed. If you agree with all these statements, please tick the checkbox. *

First Name *

Surname *

House Number/Name *

Post Code *

Email Address *

Telephone Number

Company Status *

Company Name or Trading Name *

Date Business Established *

Estimated Annaul Turnover *

Trade and business description. *

Do you use heat? *

If YES to heat. Please describe what equipment used. *

Some trades have a depth limit i.e Groundworker. Please advise maximum depth you go to. *

Please advise maximum height you may go to. *

Any claims or losses in last 5 years. Include dates, description and costs. *

Workforce

Number of Manual principals,partners *

Number of Clerical Directors,Partners *

Number of permanent workers *

Number of Clerical Workers *

Number of temporary employees *

Number of labour only subcontractors? *

Number of Bone Fide Subcontractors *

Covers

Public Liability Limit *

Employers Liability *

Contract Works *

Hired in Plant *

Portable Hand Tools *

Is cover required overnight in locked vehicle? *

Construction,plant and machinery sum insured. Enter value *

Business Stock ? Enter Value *

Date Cover Required * +