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 (inc Title):

Business Address:

Postcode:

Contact Number:

E-mail Address:

BUSINESS DETAILS

Full Description of Business Activities:

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

Details of Any Countries Imported From:

Details of Any Countries Exported 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

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. You are the sole occupants and the premises are self-contained

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

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

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

6. You 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.

7. 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

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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