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Property Owners Insurance Quotation form
mobi
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Property Owners Insurance Quotation form
Name of the Individual(s) / Company the policy is to be in
*
Risk Address including postcode
*
Contact Number
*
Your Email Address
*
Please confirm Renewal / Inception date
What describes your property type
*
Please select an option
Please advise
Flats (Converted Mansion)
Flats (Converted)
Flats (Purpose Built)
House
Individual Flat
Industrial Unit
Land Only
Office
Office with Flats Above
Retail Warehouse
Shop
Shop with Flat Above
Surgery
Surgery with Flats Above
Warehouse
Year the premises was built
Number of years you have owned the premises
*
Please select an option
Please advise
Not purchased yet
Less than a year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
Over 10 years
Please provide the number of flats
*
Please confirm the Tenancy of the flats
Lease Holder
Working Professional
Asylum Seekers
Care and Support
Holiday Home
Local Authority
Retired
Second Home
Student
Unemployed
Unemployed with Benefits
Working with Benefits
Is the request to insurer the whole of the property
Yes
No
Number of floors
*
Construction of floor
Wood
Concrete
Mixed Concrete and Wood
Rebuilding sum insured
*
Do you require loss of Rent cover
Yes
No
Please advise the loss of rent cover
Indemnity Period (Months)
12
18
24
36
48
Property Owners Limit of Indemnity
£2,000,000
£5,000,000
We have made the following assumptions
Is following information is correct?
Yes
No
1) The premises are not a Listed Building
1) Are the premises listed
Not Listed
Grade 1 Listed Building
Grade 2 Listed Building
Grade A Listed Building
Grade B Listed Building
Grade B Plus Listed Building
Grade B1 Listed Building
Grade B2 Listed Building
Grade C(s) Listed Building
Preservation Order
2) The premises has fixed Gas Central heating
2) Please confirm the type of heating a the premises
None
Fire - Open
Fire - Other
Fixed Heater
Hot Air
Night Storage Heater
Oil Heater
Portable Heaters
Pressure Jet Heaters
Radiant Panel Heater
Radiators Panel Heater
Radiators - Hot Water
Radiators - Oil Filled
Stove
2) The heating is fixed heating
Please confirm the type of fixed heaters - fuel type
Bottled Gas
Electricity
Gas
Heating Oil
LPG
Natural Gas
Paraffin
Solid Fuel
Waste Oil
wood
3) The proposer, director or partner of the Trade or Business or its Subsidiary Companies has never personally or in any business capacity:
- been convictions of a criminal offences which are not spent under the Rehabilitation of Offenders Act or has any prosecutions pending
- been declared bankrupt or insolvent or been the subject of bankruptcy proceedings or insolvency proceedings
- had a proposal refused or declined - had an insurance cancelled - had a renewal refused - had special terms imposed
Yes
No
4) There has been no losses or incidents giving rise to a claim in the last 5 years
Yes
No
Please provide details of the claims including loss date, type of loss and amount paid and outstanding
5) The premises are not in an area with a history of flooding
Yes
No
6) The property is of standard construction, the walls are built of brick, stone or concrete and the roof is slate, tile or concrete with 0% of flat roof
Yes
No
Wall construction
Asbestos
Brick
Brick / Timber Frame
Concrete
Flint
Glass
Metal
Slate
Stone
Tile
Timber
Roof construction
Asbestos
Concrete
corrugated Iron
Felt on Timber
Glass
Metal
Shingle
Slate
Tile
Timber
Woodwork
Thatch - Fibre
Thatch - Reed
% of the roof which is felt on timber
0%
0% - 5%
5% - 10%
10% - 15%
15% - 20%
20% - 25%
25% - 30%
30% - 35%
35% - 40%
40% - 50%
50% - 60%
60% - 70%
70% - 80%
80% - 90%
90% - 100%
7) The property and adjacent property have not suffered or shown any visible signs of damage from subsidence, landslip or ground heave
Yes
No
Any additional information you would like to provide
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