| Personal Detail |
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| Contact Name* : |
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| Policyholder's name, if different : |
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| Correspondence address* : |
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| Postcode* : |
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| Telephone* : |
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| Email* : |
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| Password*: |
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| Property Detail |
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| Premises address(If different) : |
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| Premises postcode* : |
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| Sum Insured |
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| Buildings : |
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The building sum insured must reflect the full cost of re-building the property should it be completely destroyed in an insured event.
The sum insured should include allowances for removal of debris, architects fees together with any outbuildings, walls and fences etc.
The current market value should not be used. |
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| Tenants improvements : |
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Tenants improvements are alterations you may make to the building, if you are not the owner.
This may include false ceilings, lighting, fitted furniture etc. |
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| Fixtures and fittings : |
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| Electronic office equipment : |
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| Stock (general) : |
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This is the purchase cost of stock - not retail value.
If you are VAT registered you should not include this part of the cost. |
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| Stock (wines & spirits) : |
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| Stock (tobacco) : |
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| Options & enhancements (leave blank for insurer's standard cover) |
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| Business interruption : |
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| Goods in transit : |
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| Money (on premises/ in transit) : |
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| Money (in safe overnight) : |
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| Frozen food : |
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| Public liability : |
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| Loss of licence : |
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| Terrorism cover : |
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Terrorism is a standard exclusion of all commercial insurance policies.
When cover for terrorism is required, this can be taken though your insurance company, although it is actually reinisured by the Government fund, Pool Re.
IMPORTANT: If you opt for terrorism cover with Pool Re, you must ensure that all your policies have this extension otherwise they will consider the cover void. Alternate cover for terrorism insurance is available through Lloyds of London, which does not have this same stipulation. |
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| Security Details |
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| Shop Front : |
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Steel Shutters
Steel Grilles
5 Lever mortise deadlock |
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| All other ground floor and accessible windows : |
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Steel Shutters
Steel Grilles
Key operated locks |
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| Rear access : |
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Steel Shutters
Steel Grilles
Key operated locks |
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| Intruder alarm : |
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| CCTV Cameras? : |
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Dummy cameras
Recorded cameras
Local authority CCTV |
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| Proprietor/ manager live on premises? : |
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| Situated in a closed shopping mall? : |
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| Constructions and Risk Details |
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Year Built (Approximate)*
(YYYY)
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| Construction of floors : |
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| Construction of stairs : |
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| Construction walls : |
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| Construction roof : |
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| Proportion flat roof : |
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Insurers must be informed of all instances of flat roofs, even if they are only small areas.
Flat roofs are notorious for failing due to storm damage and insurers will often charge an additional premium for buildings that have a significant proportion.
Insurers typically also impose an inspection warranty, where the flat roof must be inspected by a competent contractor every one to three years. |
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| Is electrical wiring system checked annually? : |
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Yes
No |
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The property should have an inspection to it's electrical wiring system at least every five years.
Many underwriters will offer a reasonable discount if it is checked every year, by an NIC EIC approved contractor. |
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| Maintained fire alarm? : |
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Yes
No |
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| Past Experience |
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| Number of years owned : |
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| Current insurers : |
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| Renewal premium : |
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Renewal/ deadline date
(dd/mm/yyyy) : |
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Claims in last 5 years - provide circumstances, date and amount
(if none - state) : |
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| Additional Information |
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| If you have a voucher code, please enter it here : |
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| Please list any other information which may influence the underwriters quotation : |
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| Help ? |
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Please tell us any details that you feel the insurers would like to know. If there is something you are not sure worth mentioning, it is best to tell us anyway.
Insurance contracts place the onus on the customer to tell the insurer all material facts, whether the insurer ask the right questions or not. |
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