FULL TRADING NAME:
POSTCODE:
TELEPHONE NO (including STD code):
POLICY DUE
E:MAIL ADDRESS:

ALL OFFICE CONTENTS (other than stock/trade samples and electronic office equipment)(£):
STOCK/TRADE SAMPLES(£):
ELECTRONIC OFFICE EQUIPMENT (including computers)(£):

PROPERTY MOVED AWAY FROM PREMISES-:
PORTABLE COMPUTERS(£):
MOBILE PHONES(£):
PHOTOGRAPHIC EQUIPEMENT(£):
SURVEYING EQUIPEMENT(£):
COMPUTER SYSTEM RECORDS(£):
SPECIAL GLASS(£):
ILLUMINATED SIGNS(£):
RENT(£):
MAXIMUM MONTHLY INDEMNITY PERIOD:	6 12 18 24 36

* ANY COMPUTER OR ANY INDIVIDUAL ITEM OF EQUIPMENT WHERE THE VALUE EXCEEDS £10,000:

PLEASE ENTER DESCRIPTION AND VALUE:

DO YOU REQUIRE A VOLUNTARY EXCESS TO REPLACE STANDARD £250 EXCESS:

NO YES

AMOUNT:

£500 £750 £1000

DO YOU REQUIRE SUBSIDENCE COVER:

NO YES

LOSS OF INCOME(£):
MAXIMUM INDEMNITY PERIOD:	12 18 24
INCREASED COST OF WORKING(£):

MAXIMUM AMOUNT OF OUTSTANDING DEBIT BALANCES LIKELY AT ANY ONE TIME(£):
ARE YOUR RECORDS KEPT IA A FIRE RESISTED SAFE OR CABINET:	YES NO
DO YOU KEEP DUPLICATES ELSEWHERE THAN AT THE PREMISES:	YES NO

IS THERE AN ALARM ON THE PREMISES:	YES NO
IS IT BELLS ONLY:	YES NO
CENTRAL STATION OR MONITORING:	STATION MONITORING
RED CARE:	YES NO
NACOSS FITTED AND MAINTAINED:	YES NO