www.uk-Office-Insurance.net
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Insurance2day
Insurance Services Ltd
 
 
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OFFICE/HOME OFFICE INSURANCE REFERRAL
If our Royal & Sun Alliance office or home office insurance scheme does not fulfil your requirements please complete your details below for a quotation from our panel of insurers.
   
Company Name (if applicable):
Contact Name (inc Title):  
Office Address:
Postcode:
Contact Number:
E-mail Address:
Business Activities :
   
OFFICE AND RISK DETAILS
   
Are The Premises Occupied Solely As Offices?
Details if, NO:
Does the Office Contain an Atrium?
Details if, YES:
Is all work undertaken of a white collar/clerical nature?
Details if, NO:
   

3 Years Claims Experience

Please give full details of all claims and losses irrespective of whether a claim has been made including date, circumstances and payments made/outstanding

   
Name of Current Insurer (if applicable):
If You Are Currently Insured, is any Long Term Agreement/Undertaking in Force?
   
COVER REQUIRED
   
Buildings Sum Insured:
Is Subsidence Cover Required?
Glass & Signs:
Fixtures, Fittings & Trade Contents:
Stock:
Examples of Type of Stock:
Computer Equipment:
Stock In Transit:
All Risks Cover for Laptops:
Money Cover:
Business Interruptions Cover:
Employers Liability:
Public Liability:
Details of Any Other Cover Required:
Date Cover Required From:
   
Any Additional Information/Comments:
 
STATEMENT OF FACT
   
1. The premises are of standard construction i.e. built with brick, stone or concrete walls and slate, tile, metal or asbestos roofs and in a good state of repair
2. You are the sole occupants and the premises are self-contained
3. Any flat roof area does not exceed 15% of total roof area
4. The premises are in an area free from flooding and subsidence
5. You have no adverse insurance, economic or personal history
6. You comply with the minimum levels of physical security i.e. all external entry/exit doors are fitted with 5 lever mortice deadlocks complying to BS3621 & all accessible windows are either barred, grilled or fitted with key operated window locks.
7. There are no other material facts that may affect an insurers willingness to offer you cover
   
If you agree with the above statements please tick here:
If you do not agree with any of the above statements please tick here and give full details below:

 
Please press the submit button below