Residential Property May 21, 2013Uncategorizedadmin Quote FormInsured Name *DOB *Occupation *e.g Factory WorkerCorrespondence Address *Postcode *Risk Address *Postcode Type of Property *----TerraceDetachedSemi-detachedBungalowFlatStandard Construction *Made out of Brick/Stone--YesNoYear Built *--YesNoOccupied Since *Building Value Building AD Cover --YesNoTelephone *Contents Value *Contents AD Cover *--YesNoAll Risk cover (Outside the Home) Legal Cover *--YesNoEmergency Home Care *--YesNo VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Commercial Property Insurance May 21, 2013Uncategorizedadmin Quote FormTitle *MrMrsDrProfMissFirst Name *Middle Name(s) Surname *DOB *Address Line1 *Address Line2 City/Town *Postcode *Risk Address Line 1 *Risk Address Line 2 City/Town *Postcode *Building value *Accidental Damage *YesNoContact Number Email *Tenant Type e.g Shop with flat Above and what type of business VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Restaurant Insurance May 21, 2013Uncategorizedadmin Quote FormName *Address *Full Address inc PostcodeBusiness Name & Address *Contents *All other contents Excl Fixture & FittingsBuilding Value *Stock In Trade *What is the value of your StockFixtures & Fittings *What is the value of your Fixtures & FittingsWine & Spirits/Tobacco *Value of Wines&Spirits/TobaccoGlass *Shop Front *e.g Shop SignageDeterioration of Frozen Foods *Loss of License *Public Liability *£1,000,000£2,000,000£5,000,000Products Liability *£2,000,000Employers Liability *£10,000,000Legal Expenses *YesNoContact Number *Email Address * VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Takeaway Insurance May 21, 2013Uncategorizedadmin Quote FormStock In Trade Fixtures & Fittings Inc Tenant Improvement Wine & Spirits/Tobacco & Cig Loss of Income (Retail Shop Only)*2 of Contents Glass (Retail Shop Only) 2,000 Standard Money (Retail Shop Only)2,000 Standard Good In Transit (Retail Shop Only)2,000 Standard Shop Front Building Loss of Rent (12 Months) Deterioration of Frozen Foods Failure of Extraction Unit Loss of License Employers Liability Public Liability Property Owners Liability Products Liability Legal Expense Other VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Retail Shop, Offices & Event Insurance May 21, 2013Uncategorizedadmin Quote FormStock In Trade Fixtures & Fittings Inc Tenant Improvement Wine & Spirits/Tobacco & Cig Loss of Income (Retail Shop Only)*2 of Contents Glass (Retail Shop Only) 2,000 Standard Money (Retail Shop Only)2,000 Standard Good In Transit (Retail Shop Only)2,000 Standard Shop Front Building Loss of Rent (12 Months) Deterioration of Frozen Foods Failure of Extraction Unit Loss of License Employers Liability Public Liability Property Owners Liability Products Liability Legal Expense Other VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Travel Insurance May 21, 2013Uncategorizedadmin Quote FormName: *Address: *Date Of Birth *How Many People to Travel over 18? *How Many People to Travel under 18? *Telephone Number *Email Address * VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Fleet Insurance May 21, 2013Uncategorizedadmin Quote FormTitle MrMrsDrProfMissFirst Name *Middle Name(s) Surname DOB *Age Gender *MaleFemaleDaytime Telephone Mobile Telephone Email *Address Line1 *Address Line2 City/Town *Postcode *Please provide basic details of your enquiry: * VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Breakdown Cover May 21, 2013Uncategorizedadmin Quote FormName: *Address: *Date Of Birth *Vehicle Make *Vehicle Model *Vehicle Value *Telephone Number *Email Address * VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Excess Protection May 21, 2013Uncategorizedadmin Quote FormName: *Address: *Telephone Number *Email Address * VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank:
Taxi Insurance May 21, 2013Uncategorizedadmin Quote FormTitle *MrMrsDrProfMissFirst Name *Middle Name(s) Surname *DOB *Gender *MaleFemaleMarital Status *-----MarriedSingleDivorcedCo-HabitingWidowedAddress Line 1 *Address Line 2 *Town/City *Postcode *Use Of Vehicle *Private HirePublic HireHow many years have you held your Full Uk Licence? *Licensing Authority *Taxi Experience Registration Number *Please Enter Your Vehicle Registration NumberMake/Model of Vehicle *Vehicle Value *No Claims Discount *0123456789+Accidents In the last 5 Years Motoring Convictions in the last 5 Years Disabilites Access to other Vehicles *Uk Residence *How Long Have you lived in the UKPhone *Renawal Date *Driving Licence Number * VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - please leave it blank: