Wholesalers Insurance

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

COMPANY DETAILS

Company Name:

Contact Name - Title & Surname:

Contact Name - First Name:

Business Address:

Postcode:

Contact Number:

E-mail Address:

BUSINESS DETAILS

Full Description of BusinessActivities:

If You Re-Package &/or Re-Brandplease give full details:

Details of Any CountriesImported From:

Details of Any CountriesExported To:

Number of Years Trading:

Renewal Date:

Target Premium (£):

COVER REQUIRED

Buildings Sum Insured (£):

Is Subsidence Cover Required?

Glass & Signs (£):

Fixtures, Fittings, Plant & Machinery (£):

Stock (£):

Examples of Type of Stock:

Non Ferrous Stock (£):

Computer& Electronic Office Equipment (£):

Optional Extensions:

Stock In Transit (£):

All Risks Cover for Laptops (£):

Glass Cover (£):

Money Cover (£):

Business Interruptions Cover (£):

Any Other Cover Required:

PUBLIC LIABILITY

Limit of Indemnity:

Estimated Annual Turnover (£):

Details of Any Exports:

EMPLOYERS' LIABILITY

Limit of Indemnity:

Clerical/Managerial Wage Roll (£):

No of Clerical/Managerial Employees:

Manual Wage Roll (£):

No of Manual Employees:

Details of Work Away From Premises:

Additional Information:

Details of Work Outside of U.K.:

STATEMENT OF FACT

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:

Comments

ADDITIONAL INFORMATION

Are the premises protected by a N.A.C.O.S.S. approved alarm?

Is Police Response Operational?

Are the premises protected by CCTV?

Please detail any other security factors:

Details of ALL and ANY claims or losses in the last five years:

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