Leisure Insurance Quote Form

Please complete the form below to receive your quote
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Date cover required from

Current insurance held with

Current insurance premium

How did you hear about us?

—Please choose an option—AI OverviewChatGPTClaudeGeminiCoPilotMetaGoogle Web SearchGoogle Sponsored ResultGoogle AdYahoo Web SearchBing Web SearchOther Web SearchFacebookXLinked InRecommendationExisting clientWord of mouthAdvertisementOther

Contact name*

Company name

Telephone number*

Email address*

Business address

Town

Postcode*

Location of premises*

—Please choose an option—Business park unitRetail parkIndustrial unitUnit within indoor shopping centreSelf-contained premises within multi tenure millResidential streetsideHigh streetIndoor leisure complexResidentialMulti-tenant buildingOffice blockOther

If 'Other', please provide details

Business description

What is the insured’s trading type?*

—Please choose an option—IndividualSole TraderPartnershipLimited Liability Partnership (LLP)Limited CompanyNon-Limited CompanyPublic Limited Company (PLC)Charity OrganisationCommunity Interest Company – CICOther

If 'Other', please detail

Website

Number of years trading in total

Have you had any claims in the last 5 years?*

—Please choose an option—YesNo

If 'Yes', please detail dates, incidents & amounts

Please provide a detailed list of all the facilities and activities provided

Is frying equipment used?*

—Please choose an option—YesNo

SUMS INSURED – IF A NEW VENTURE, PLEASE PROVIDE YOUR BEST ESTIMATES

Buildings

Do you require subsidence cover?*

—Please choose an option—YesNo

Tenants improvements

Computers, cash registers & other electronic business equipment

All activity and play equipment

All other contents, fixtures & fittings

All other stock

Wines & spirits

Beers

Frozen or refrigerated stock

Glass

Signs & canopies

Money (during business hours)

Money (after business hours in a locked safe)

Type of safe on the premises*

—Please choose an option—No safe on premisesSafe installed and operated correctly

Goods in transit

Maximum business interruption cover required

Maximum business interruption indemnity period required*

—Please choose an option—12 months18 months24 months36 months

Loss of rental income

Outstanding debit balances (book debts)

Loss of licence

Public liability indemnity limit*

—Please choose an option—£1,000,000£2,000,000£5,000,000£10,000,000

Your annual turnover

Number of employees

Your annual staff wageroll

Your Employers Reference Number (ERN)

Do the premises have an intruder alarm?

—Please choose an option—NoYes - bells/audible onlyYes - digital communicatorYes - central station

Does your alarm have police response?

—Please choose an option—NoYes - Level 1Yes - Level 2Yes - Level 3

Do the premises have CCTV?

—Please choose an option—YesNo

Do the premises have a fire alarm?

—Please choose an option—YesNo

What year were the premises built?

—Please choose an option—Pre 18511851 - 19201921 - 19391940 - 19791980 - 19891990 - 19992000 & later

Notes, if any

DECLARATION

You or any director or partner in any business, any partner in any partnership, any director of any company, or the company;
either in any personal capacity, in the name of the business proposed or in respect of any other business in which any of you have ever had an interest have:

- Never had a proposal for insurance declined, cancelled or refused;
- Never had insurance cancelled mid-term, a renewal refused, increased or special terms or conditions imposed by an insurer;
- Never been given an official police caution, convicted of, charged (but not yet tried) or have any prosecution pending for any offence (excluding any motoring convictions and any offences which are spent under the Rehabilitation of Offenders Act 1974);
- Never been the subject of or issued with a County Court Judgement (CCJ), money judgement or court decree and/or ever been cited in any unsatisfied court judgements (or the Scottish equivalent) or any other judgements or decrees in relation to debt;
- Never been declared bankrupt or insolvent, the subject of an individual voluntary arrangement (IVA) or company voluntary arrangement (CVA) with creditors, voluntary liquidation, a winding up or administration order, or administrative receivership proceedings, bankruptcy or insolvency proceedings;
- Never been disqualified from being a company director;
- Never been censured by any regulatory or trade body or any action been taken against the company by the office of fair trading, consumer groups or the alike;
- Never been served under any Health & Safety, Welfare, Environmental, Consumer Protection or Food Safety legislation or any other legislation, with any warnings, enforcement measures, prohibition notice, improvement orders, proceedings or criminal proceedings by any Health and Safety Executive, Environmental Health Office, Environment Agency, local or government authority or any other enforcement agency or authority;
- Never been convicted of, charged (but not yet tried) with, officially cautioned or have any prosecution pending for a breach of any Health & Safety, Welfare, Environmental, Consumer Protection, Food Safety legislation or any other legislation;
- Never been the subject of a recovery action by Customs and Excise or the Inland Revenue.

Please confirm if you agree with the declaration*

—Please choose an option—Yes - I agree with the declarationNo - I do NOT agree with the declaration

If you DO NOT agree, please advise why here

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