insurance2day


Insurance2day Insurance Services Ltd are authorised and regulated by the Financial Services Authority and are members of:





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    Business Name:
    Please State if Limited Company:
    Contact Name (inc Title):
    Business Address:
    Postcode:
    Contact Number:
    E-mail Address:
    Renewal Date:
    Name of Existing Insurers:
    Target Premium (£):
    Date Business Established:
    Description of Business Activities:
    COVER REQUIRED
    Maximum Value Any One Contract (£):
    Maximum Period Any One Contract (months):
    Sum Insureds:
    Own Plant & Equipment (£):
    Max Value Any One Item of Hired in Plant (£):
    Estimated Annual Hire Charges (£):
    Estimated Annual Turnover (£):
    Details of Any Work Outside of U.K.:
    ADDITIONAL INFORMATION
    Please Give Details of ALL and ANY Claims/Losses You Have Suffered In The Past 5 Years:(please advise date(s), cost(s) and circumstances)
    Have You Ever Had an Insurance Policy Cancelled or Special Terms Imposed?
    Any Additional Information/Comments:
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