LISTED PROPERTY QUOTATION REQUEST

Simply complete the form below and we will send you your quotation by return. All quotations provided, whether written or verbal, are subject to confirmation through the completion of a proposal form (which will be sent to you). Terms, premiums and conditions may change if the information given in the proposal form is different from that disclosed by you at quotation stage.

 
 
Surname
 
 
Address of property to be insured
 
Postcode
 
 
Date of birth
 
Occupation
 
 
Correspondence address
(if different
from above)
 
 
Telephone
 
Email
 
 
 
 
 
 
 
 
If "Yes", please give details:
 
 
    
 
If "Yes", please give details:
 
 
How old is the building?
 
 
Construction of the property:
Walls: Roof:
 
 
Smoke detectors  
Fire blanket
Fire extinguishers
Spark arrestor
 
 
When was the electrical installation last inspected?
 
 
Are all external doors secured by 5-lever mortice deadlocks or cylinder locks complying to BS 3621?
If you have answered “No” please provide details of the security:
 
Are all opening, accessible windows fitted with key-operated locks?
If you have answered “No”please provide details of the security:
 
Please provide details of any alarm system:
 
Bell/siren only  
Redcare
Central station  
Digital communicator
           
Is the alarm maintained annually by a NACOSS approved company?
Yes    No
 
 
Please provide brief details of any other security arrangements (e.g. safe, Neighbourhood Watch etc.):
 
 
Please specify sums insured required:
Buildings
  £   Cover: Accidental Damage
General contents
  £   Cover: Accidental Damage
Antiques*
  £   Cover: Accidental Damage
Pictures*
  £   Cover: Accidental Damage
Silver & plate
  £   Cover: Accidental Damage
Jewellery
  £   Cover: All Risks, Worldwide
Personal effects
(cameras, watches etc)
  £   Cover: All Risks, Worldwide
Pedal cycles
  £   Cover: Accidental Damage
 
*Can be included under “ General Contents” but attract a lower rate if separately listed.
 
Excess preferred (there is a compulsory £1,000 landslip, subsidence and heave excess and £50 all other claims):
 
 
 
 
£100  
£100  
 
£150  
£150  
 
£250  
£250  
 
£500  
£500  
 
£1000  
£1000  
 
 
Have you or any other person living with you sustained any loss or damage during the past five years (which would have been covered by this type of insurance had it been in force) whether or not a claim was made?
 
If "Yes", please provide date, details and amount of each loss or damage incident below:
Date
 
Details
 
Amount
 
 
£
         
 
 
£
         
 
 
£
         
 
 
£
         
 
 
£
 
 
 
Telephone
Email
 
Post
Fax
        Fax number:
 
 
Current renewal date?
Existing Insurer?
How did you hear about us?
 
 
Additional comments: