Proposer's Name
Contact Name
Address		Postcode	A value is required.
Telephone	A value is required.	Email	A value is required.Invalid format.
Business Description
No of Years In Business		Number of Employees
Renewal Date		Renewal Premium

Property Details

-Walls - Brick Brick/Steel Steel Wood Concrete Other - Floors - Concrete Stone Wood Other - Roof - Slate Steel Concrete Timber/Felt Other - Heating - Gas CH Electric Oil Portable Heaters None - Electrics Checked - Less than 12 months Less than 3 years Less than 5 Years Other - Intruder Alarm - BT Redcare Digital Commmunicator Bells Only None - Alarm Maintained - Yes No

- Other Occupants - Yes No
Address of Property if different

Sums Insured / Estimates
Buildings	£
Loss of rent	£
Stock (ex non ferrous metals)	£
Stock of non-ferrous metals	£
Contents (ex Computers)	£
Computer Equipment	£
Tenants Improvements	£
Deterioration of Frozen Stock	£
Business Interruption (Loss of Profits)	£
Business Interruption Indemnity Period	Months
Book Debt	£
Clerical and Sales Wages	£
All Other Employee Wages	£
Manual Work Away Wages (ex bona-fide sub-contractors	£
Payments to bon-fide sub-contractors	£
Heat Work Away	£
% of manual work relating to heat work away	%
Annual Turnover	£
Goods in Transit	£
Contractors All Risks / Contract Works
Maximum Value any one contract	£
Maximum Contract Period	months
Hired in Plant - please provide annual hire charges	£
Own plant, tools, equipment and temporary buildings	£
Employees tools and personal effects	£

Specified All Risks	Description of Items	Europe or Worldwide	Sum Insured
		Europe Worldwide	£
		Europe Worldwide	£
		Europe Worldwide	£
		Europe Worldwide	£
		Europe Worldwide	£

Legal Expenses	No Yes
include Contract Cover	No Yes

Claims	Date	Cause	Amount