General
Information
|
|
| How
many years has the business been trading? |
|
| Type
of premises (e.g. factory, warehouse, etc.): |
|
Type
of area that the premises are located:
(e.g. commercial, industrial, residential, rural, etc.) |
|
| Is
there a written health and safety policy in place? |
Yes
No |
Has
any insurer ever refused, declined,
cancelled or imposed special terms? |
Yes
No |
Have
you or any partner or director ever been
convicted of or charged with any criminal offence? |
Yes
No |
Have
you or any partner or director ever
been declared bankrupt or insolvent? |
Yes
No |
| What
year were the premises built? |
|
Are
you the sole occupant(s) of the
building in which your premises are situated? |
Yes
No |
If
no, please provide details of the type(s)
of business carried out by the other occupants: |
|
Is
your portion of the building(s) self-
contained with their own means of access: |
Yes
No |
| If
No, please provide details: |
|
| Construction
of Walls (e.g. brick, stone, etc.): |
|
| Construction
of Roof (e.g. tile, slate, etc.): |
|
| Construction
of Floors (e.g. concrete, wood, etc.): |
|
| Please
state the number of storeys: |
|
Are
there any basement
floors or below ground level? |
No
Yes |
Are
any parts of the
building at present unoccupied? |
No
Yes |
| If
yes, please provide details: |
|
| How
are the premises heated (i.e. gas, oil, etc.): |
|
| Do
you use portable heaters? |
No
Yes |
When
were the electrics in the building
last inspected by a qualified electrician? |
|
Are
all your external doors fitted with a minimum
of 5 lever mortise deadlocks that comply with
BS3621(look for the British Standard Kitemark)? |
No
Yes |
Are
all opening windows fitted
with key operated window locks? |
No
Yes |
| Are
your premises protected by a burglar alarm? |
No
Yes |
| If
yes, is the alarm N.A.C.O.S.S. approved |
No
Yes
Not Sure |
Does
the alarm include 'REDCARE' signalling?
(i.e. telephone signalling to the
police in the event of alarm activation) |
No
Yes |
Please
provide details of
any other security arrangements:
(e.g. shutters, window grilles, etc.) |
|
| Do
the premises have fire extinguishers fitted? |
No
Yes |
| Do
the premises have a sprinkler system installed? |
No
Yes |
What
smoking policy is in force?
(select whichever is applicable) |
Smoking is banned
No policy is in force
Smoking is restricted
to designated areas |
Have
you or any other director or partner (in this
or any other trading name) suffered any loss or had
any claims made against you in the last 5 years? |
No
Yes |
If
yes, please provide details i.e. date of claim,
description of claim, amount claimed, etc.: |
|
Property
Cover
|
| Level
of Cover Required? |
|
| Property
Insured |
Buildings
Sum Insured including outbuildings,
rebuilding architects' fees, removal of debris, etc: |
|
| Is
subsidence cover required? |
No
Yes |
Tenants
Improvements Sum Insured:
(i.e. improvements you have made
to the property, if you are a tenant) |
|
Plant/Machinery/Contents
Sum Insured:
(excluding computers/electronic equipment) |
|
| Computers/Electronic
Equipment Sum Insured: |
|
| Wines
& Spirits Sum Insured: |
|
| Cigarettes
& Tobacco Sum Insured: |
|
General
Stock Sum Insured:
(excluding wines, spirits, tobacco, non-ferrous metals,
jewellery, watches, furs, precious metals & explosives) |
|
| Other/High
Risk Stock Sum Insured: |
|
| Type
of Other/High Risk Stock (if applicable): |
|
| Glass
Cover (if required) |
| External
Fixed Glass: |
|
| External
Signs and Blinds: |
|
| Money
Cover (if required) |
| Money
cover during business hours: |
|
| Money
cover out of business hours in a locked safe: |
|
