Unoccupied Residential Property Insurance

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

PROPOSER DETAILS

Contact Name - Title & Surname:

Contact Name - First Name:

Company Name: (if applicable):

Contact Number:

E-mail Address:

Renewal Date:

Target Premium (£):

PROPERTY DETAILS

Risk Address:

Postcode:

Approx. Date Property Built:

Property Type:

Details If Other:

Business Activities of Prospective Tenant(s):

Occupancy Status:

Details if OTHER:

Details of Security Measures in Place:

COVER REQUIRED

Buildings Sum Insured (£):

Is Subsidence Cover Required?

Property Owners Liability:

Landlords Contents Sums Insured (£):

Employers' Liability:

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. 	The premises are self-contained

3. 	Any flat roof area does not exceed 15% of total roof area

4. 	The buildings are not Grade I or II listed

5. 	The premises are in an area free from flooding and subsidence

6. 	No structural work is to be undertaken.

7. 	A CORGI registered contractor will inspect and service all gas appliances at least every 12 months and any necessary repairs and maintenance will be carried out by a member of CORGI.

8. 	A NICEIC registered contractor will inspect and service all electrical appliances when the property is let out for the first time and then once every 5 years and all wiring will be checked at least every 10 years.

9. 	All upholstered furniture meets the Fire and Furniture Regulations Act. Any furniture added to the property after 1st March 1993 adheres to the relevant fire resistance requirements.

10. You have no adverse insurance, economic or personal history

11. The premises 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.

12. 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:

Comments

CLAIMS/LOSSES

Please details of ALL and ANY losses you have suffered or claims you have made in the last five years (please advise date(s), cost(s) and circumstances:

Any Additional Information/Comments:

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