Name	A value is required.	Contact Name
Address		Postcode	A value is required.
Telephone	A value is required.	Email	A value is required.Invalid format.

Business Description	Please Choose Hotel Guest House	No of Years In Business		Number of Employees
Claims Experience	Date	Cause	Amount

-Walls - Brick Brick/Steel Steel Wood Concrete Other - Roof - Slate Steel Concrete Timber/Felt Other - Floors - Concrete Stone Wood 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

Is there a nightclub or discotheque on the premises?	No Yes	Is there any form of entertainment on the premises?	No Yes
Please describe any Entertainment
Do your directly employ any doormen?	No Yes	Does the premises have a late license?	No Yes
Is a separate admission charged for any entertainment	No Yes
Does the premises have an outside children's play area	No Yes	if so are there 4 items of apparatus or less, and is safety flooring/matting present?	N/A No Yes
Is cover required for inflatable's?	No Yes	Please provide details of any fish frying range	None 1 Year Old 2 Year Old 3 Year Old 4 Year Old 5 Year Old Under 10 Years Old Over 10 Years Old
Do you have accommodation let in any part to DSS, students or asylum seekers?	No Yes
Buildings	£	Trade Contents	£
Domestic Contents	£	Stock	£
Wines Spirits	£	Tobacco and Cigarettes	£
Business Interruption	£	Employers Liability	£10,000,000 £20,000,000
Public Liability	£2,000,000 £5,000,000 £10,000,000	Products Liability	£2,000,000 £5,000,000 £10,000,000
Premises during Business Hours or in transit or bank night safe		Premises or private dwelling outside Business Hours in a safe 500
Premises outside Business Hours not in a safe		Private dwelling out of Business Hours
Frozen Food		Loss of License
Outstanding Debit balances