Quote Form

Where Shopkeepers are Welcome.

Please complete the Quote Form below:

Any Queries call 01989 565613.


About You.

Title: Email Address
Forename: Daytime Telephone:
Surname: Mobile

About Your Shop.

Address Line 1: Town/City:
Address Line 2: Region/County:
    Postcode:
How long have you been established? Buildings Sum Insured (if required)
Date of Renewal dd/mm/yyyy   
Is the property standard construction (brick/slate/stone/tile) Yes No
Trade Type
Contents/Fixtures & Fittings Sum    
Primary Stock Type Primary
Primary Stock amount to be insured:
 
Other Stock Type
Other Stock amount to be insured:
 
Frozen Food Amount to be insured:
Is the property an office? Yes No
Cost of Office Computer Equipment:
Alarm Type Grills or Shutters  Yes No
Any Local Authority CCTV  Yes No Do you live on the premises?  Yes No
Have you had any property insurance claims or losses in the last 3 years? Yes  No
Dates & Details of Claims within the last three years including amount and type.
Any further details which you feel may affect your application?

 







image
image
image