Property Owners Insurance Quote Form

Please leave this field empty.

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 searchFacebookXLinkedInRecommendationExisting clientWord of mouthAdvertisementOther

CONTACT DETAILS

Contact name*

Telephone number*

Email address*

Have you had any claims in the last 5 years?

—Please choose an option—YesNo

Name of insured

(Please enter the full name(s) and any trading names as they should appear on policy documents)

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

Correspondence address

Town

Postcode

INTERESTED PARTIES

Do you need to note the interest of an interested party?

—Please choose an option—YesNo

PROPERTY DETAILS

Property risk address

Town

Postcode

Date property purchased

Classification of property

—Please choose an option—CommercialResidentialMixed

Property type

—Please choose an option—Industrial unitOfficeOffice with flats aboveWarehouseShopShops with flats aboveShopping centreResidentialCommercialMillHouseFlatsApartmentsHMOBedsitsOther

Number of self-contained units at the property

Is the property occupied?

—Please choose an option—YesNo

Occupancy description

Does any frying take place at the property?

—Please choose an option—YesNo

SUMS INSURED (REINSTATEMENT VALUES)

Buildings

Landlord contents

Glass

Loss of rental income per annum

Loss of rental income period required

—Please choose an option—12 months18 months24 months36 monthsNot required

Property owners liability of indemnity

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

Do you require subsidence cover?

—Please choose an option—YesNo

Do you require accidental damage cover?

—Please choose an option—YesNo

Do you require legal expenses cover?

—Please choose an option—YesNo

Do you require terrorism cover?

—Please choose an option—YesNo

What year was the property built?

Number of storeys

Is the property built of standard non-combustible construction (walls built of brick, stone or concrete)?

—Please choose an option—YesNo

Does the property have a roof constructed of slate, tile, metal or concrete, excluding any flat roof area?

—Please choose an option—YesNo

Is any part of the roof flat?

—Please choose an option—YesNo

Does the property construction have any pre-fabricated insulation panels, composite panels or wall linings?

—Please choose an option—YesNo

Does the property have a listed status?

—Please choose an option—YesNo

How is the property heated?

—Please choose an option—Fixed gasFixed electricFixed oilFixed space heatersHVAC systemHeat pumpSolid fuel burnerCoal or biomass heatingUnderfloor heatingSolar heatingFixed thermal storageFixed infrared heatingFixed LPGNo heatingOther

Do the premises have an open fire, woodburning or multifuel stove?

—Please choose an option—YesNo

Are there any adjoining buildings/properties?

—Please choose an option—YesNo

Has the property ever experienced flooding, or is it located in an area prone to flooding?

—Please choose an option—YesNo

The property is free from, and in an area which is free from any signs of subsidence, heave and/or landslip?

—Please choose an option—YesNo

SECURITY DETAILS (UNDER YOUR CONTROL)

Does the property have an intruder alarm?

—Please choose an option—NoYes - bells audible onlyYes - digital communicator to keyholderYes - digital communicator to monitoring stationYes - central station monitored dual pathYes - central station monitored single path

Does the property have an integrated mains wired fire alarm?

—Please choose an option—NoYes - bells audible onlyYes - central station monitored

Does the property have CCTV?

—Please choose an option—NoYes - Internal onlyYes - External onlyYes - Internal & external

Does the property have shutters, bars or grills to windows and doors?

—Please choose an option—NoYes - Windows onlyYes - Doors onlyYes - Windows and doors

Does the property have 24-hour onsite security?

—Please choose an option—YesNo

ADDITIONAL INFORMATION

Do you want to bring any further information or material facts to the underwriters attention?

—Please choose an option—YesNo

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

Δ