ABOUT
YOU
Your
name
Mr
Mrs
Miss
Ms
Other
:
First name .....................Surname
Your
business name, if any:
Your
postal address line 1:
Address
line 2
Town
or City:
Postcode:
E-mail:
Daytime
telephone :
Best
time for us to telephone you:
Any Time 9.00am to 5.00pm
Morning 9.00am to Noon
Lunchtime Noon - 2.00pm
Afternoon 2.00pm - 5.00pm
(Mon to Fri)
Please
describe your occupation and your partner's
occupation:
What
is your date of birth?
ABOUT
THE PROPERTY TO INSURE
Address line 1:
Address
line 2:
Town
or City:
Postcode:
How
long has the property been empty for?
Currently occupied
Under 1 month
1-3 months
3-6 months
6-12 months
Empty for over 12 months
What
sort of property is this?
Please select
Business only
Business with residential flat/s above
Detached Bungalow
Detached House
Coach House
End-terraced bungalow
End-terraced House
Flat only (ie NOT the entire building)
Flats - Converted House
Flats - Purpose built
Maisonette
Mid-terraced bungalow
Mid-terraced House
Semi-detached Bungalow
Semi-detached House
How
many bedrooms does the property have?
Please select
0
1
2
3
4
5
6 or more
Which year
was the property built?
Is it a "listed" property
No
Grade I
Grade II*
Grade II
Grade A
Grade B
Grade B+
Grade B1
Grade C
Please advise
the re-building cost
£
Click here for a calculator
What
is the construction of the walls?
Brick
Cob
Other
Stone
Timber
Construction
of the pitched roof, if any?
Tile
Metal
Slate
Thatch
Not pitched - 100% flat
Other
What
percentage of the roof is flat?
None
Under 20%
Between 21% and 30%
Between 31% and 40%
Between 41% and 50%
Over 50%
%
What
is the construction of the flat roof, if any?
Describe
the works being undertaken :
Please select
Redecorating only
Modernisation - no structural
Modernisation including structural
Conversion to flats
Commercial to residential
Residential to commercial
Barn conversion
Other (please state below)
How
long do you estimate the works will take?
Under 3 months
Between 3 - 6 months
Between 6 - 12 months
Over 12 months
How
much do you estimate the works will cost?
Up to £10,000
Up to £20,000
Up to £30,000
Up to £40,000
Up to £50,000
Up to £60,000
Up to £70,000
Up to £80,000
Up to £90,000
Up to £100,000
Other (please state below)
What
do you intend to do with the property after
renovating it?
Please select
Occupy it as my home
Occupy it as a business
Let it as residential
Let it as commercial
Sell it as residential
Sell it as commercial
Does
it have 5 lever mortise deadlocks on all final
exit doors and key operated locks on all accessible
windows
No
Yes
Double-glazed doors with multi- point locking
are also acceptable
Has the
area ever been flooded?
No
Yes
How much
excess would you prefer?
£50
£100
£250
£500
£1,000
£5,000
£10,000
Have you had any claims in the past 5 years?
No Yes
Please advise the date, what happened and how much was paid out:
Would you prefer COMPREHENSIVE cover or the cheaper "Fire, Lightning, Explosion and Impact by Aircraft (FLEA) cover? Both policies usually include property owners liability.
Comprehensive
FLEA (basic cover)
Comprehensive is not always available.
If
there is anything we have failed to ask but
could affect your quotation, please enter details
in the area below. This will help us give you
a more accurate quotation.
