Helpline: 01392 287400

Quotation Request

Commercial Property Owners

Client Details
Statement of Fact
Risk Information
Cover Requirements
Proposed Works
Subsidence Questionnaire
Additional information and declaration
Cover Details
Notes
Documents Only

Client Details

Proposers Name
Trading Name(s) if applicable
Full Time Occupation
Correspondence Address
Is the address of the property to be insured to be the same as the correspondence?
Address of Property to be Insured
Daytime Telephone
Mobile
E-Mail Address


What is the renewal or expected start date of this policy

Statement of Fact

You must take care in answering all questions being asked as Failure to accurately disclose material facts or circumstances could result in the policy being invalidated. Should You be in any doubt as to whether information is accurate or material, You should contact us for guidance. If in doubt, You should disclose it. We are keen to work in partnership with You to avoid any misunderstandings.
Material facts and circumstances are those which the Underwriter may wish to know in deciding whether to underwrite the risk and/or the terms upon which to underwrite the risk. They may be relevant either to the physical risk or to the personal background and characteristics (including financial) of You and/or any director, partner, officer and/or principal of Your Business. It is important that Your Business should have a system in place to ensure that all material facts and circumstances are disclosed.
Have You or any director, partner, officers or principal of the proposer been the subject of a County Court Judgement, bankruptcy order or an individual voluntary arrangement with creditors or been a director, partner or principal officer of any company which has been the subject of Liquidation, Receivership, Examinership, or Winding Up or Administration Order, or Administrative Receivership, or which became insolvent during that time?
Please give details
Have You or any director, partner, officer or principal of the proposer been convicted of, cautioned or have a prosecution pending for any criminal offence other than motoring offences?
Please give details
Have You or any director, partner, officer or principal of the proposer been the subject of an investigation by any taxation authority?
Please give details
Have You or any director, partner, officer or principal of the proposer ever been investigated or prosecuted for any breach of the Factories Act, Health and Safety at Work Act, Control of Substances Hazardous to Health Regulations, Health and Safety Executive Regulations, Employment Law or current legislation applicable to Your Business or trade?
Please give details
Have You or any director, partner, officer or principal of the proposer ever been served with a Prohibition Notice under the Health and Safety at Work Act or other health and safety regulations?
Please give details
Have any Insurers ever declined Your insurance proposal, refused to renew or cancelled Your Policy or imposed special conditions?
Please give details
Please provide your VAT Registration Number
Have You sustained any loss or damage during the last 5 years whether insured or not at these Premises or any other premises owned or occupied?
Please provide details of all claims below
Type of LossDate of LossAmount of LossClaim StatusClaim Details
Add row

Risk Information

Is the property ever left unattended for more than 21 consecutive days?
Please give details
Does the building have any flat roof areas
What percentage of the total roof area is flat?
%
Has the roof been inspected by a competent contractor within the last 5 years?
Is the property at least 250m away from any, sea, river, stream, lake or similar watercourse?
Please give details
Is the property in the vicinity of any cliffs, quarries or known underground workings?
Please give details
Is the property free from cracking or any visible signs of subsidence, landslip &/or heave?
Please give details
Is the property secure against weather, wind, storm &/or ingress of water?
Please give details
Is the property secure from any unauthorised &/or illegal entry?
Please give details
Number of storeys
Please state the type of property
Does the Building contain any composite panels?
Please give details
Please provide the manufacturer of the composite panels
Does the Building contain any basements or cellars?
Please give details:
Is the heating system linked to a thermostat which automatically activates the heating system when the temperature falls below 6oC (six degrees Celcius)?
Please give details:
Are all water tanks, apparatus or pipes within the Premises fully lagged?
Please give details:
Please give details:
Are the Premises compliant with gas safety regulations and do You maintain inspection records as required by law?
Please give details:
Are the Premises compliant with all safety regulations required to let the Premises to tenants?
Please give details:
Does the property have an electrical certificate issued by a NICEIC / ECA / SELECT registered electrical contractor within the last 5 (five) years and showing that any / all C1 or C2 defects have been rectified?
Please provide details:
Year Built
Property ever been monitored for subsidence, landslip or heave?
Please give details
Has the property or area within 250m of the property ever flooded?
Please give details
Are there any trees/shrubs over 3m (10ft) high within 7m (22ft) of the building?
Please give details
Please give details:
Are the whole Premises protected by an Intruder Alarm installed by an NSI or SSAIB approved installer?
Please provide details:
Does the system provide Level 1 Police Response
Is the system under your sole control?
Is the system fully maintained and under an annual maintenance contract by an NSI or SSAIB Installer
Are the whole Premises protected by Fire Alarm installed by an approved installer?
Please provide details:
Is the system under your sole control?
Does the system provide automatic Fire Brigade Response?
Is the system fully maintained and under an annual maintenance contract by an approved Installer
Are any of the following devices fitted and operational at the premises:-
Fixed fire sprinkler or suppression system
Portable extinguishers
Hoses
Smoke detectors mains wired

Construction Details

Please give details
Is the property subject to any preservation order or listed?
Please give details
Will You occupy any part of the premises?
Please provide details:
Is the building multi tenure?
Please provide details of each tanant
Tenant NameOccupation
Add row
Are any parts of the property used for residential purposes
Please give details:
Are any adjoining & neighbouring properties all occupied?
Please give details:
Will any burning of waste be undertaken at the premises?
Please give details:
Do You plan to undertake any building works, refurbishment, redecoration or demolition at the property?
Is there a mortgage or other charge against the Property to be insured which should be noted on the Policy?
Please provide details of one or more interested parties below
Click on the + or - to add or remove an Interested Party
NameAddress Line 1Address Line 2TownCountyPost CodeRef
Add row
Do you wish to disclose any additional information about this property that you feel may be important to an underwriters assessment of this risk?
Please provide any additional information or further details here

Cover Requirements

It is important that You ensure the values given below are adequate, as under-insurance may reduce the amount of recovery in the event of a claim.

 
Full Perils fire, lightning, explosion, aircraft, or other aerial devices or articles dropped there from, riot, civil commotion, strikers, locked¬ out workers, persons taking part in labour disturbances, malicious persons, theft, earthquake, storm, flood, overflowing or leaking of any sprinkler apparatus, escape of water from any tank apparatus or pipe, impact by any road vehicle or animal, falling trees branches and falling aerials including subsidence, ground heave and landslip
Full Perils excluding Subsidence fire, lightning, explosion, aircraft, or other aerial devices or articles dropped there from, riot, civil commotion, strikers, locked¬ out workers, persons taking part in labour disturbances, malicious persons, theft, earthquake, storm, flood, overflowing or leaking of any sprinkler apparatus, escape of water from any tank apparatus or pipe, impact by any road vehicle or animal, falling trees branches and falling aerials
Unoccupied Wider Perils fire, lightning, explosion, aircraft or other aerial devices or articles dropped there from, riot ,civil commotion, strikers, locked¬ out workers, persons taking part in labour disturbances, earthquake, storm, flood or impact by any road vehicle or animal, falling trees, branches and falling aerials.
Unoccupied Limited Perils fire, lightning, explosion and aircraft
 
Terrorism - Material Damage
£
Terrorism - BI
£
 
Building Sum Insured
£
Do you wish to include accidental damage to Buildings?
 
Landlords General Contents Sum Insured
£
Gross Rentals (Sum of monthly rental income multiplied by monthly Indemnity Period required)
£
Increase in Costs of Working
£
 
 
Employers Liability Cover Required
Compulsory insurance if you employ staff in connection with your business covering legal liability for bodily injury sustained by any Employee arising out of his or her employment by You in the course of the Business.
Limit of Indemnity £10,000,000 (in respect of property owners risk only).
Any one occurrence or series of occurrences arising out of any one event (Inner limits apply)
Annual Wageroll (Clerical / General Maintenance, Repair and Security Wages / Caretaker, Internal Cleaners and Gardeners)
£
/
 
POL Fee
£
Material Damage Excess

Proposed Works

Building Work; Important Information Please Note:-
It is a warranty of the policy that any electrical, gas, heating, structural and major plumbing or groundwork's are undertaken by a suitably qualified tradesman / or contractor holding a current public liability insurance policy with a minimum limit of indemnity of £1,000,000
Will the work involve the use of, or application of any heat processes?
Please give details
Will any work be of a structural nature?
Please give details
Will any work require excavations in excess of 2 metres?
Please give details
Please provide a full description of all work to be undertaken at the property
Will the services of building contractors or professional tradesmen be engaged to undertake the work?
Please give details
Will the premises / site be fenced and secured against unauthorised access during the works?
Please give details
Will the work be subject to a building contract (ie JCT)?
Please give details
Does the contract require Joint Names insurance?
Please give details
What is the contract value or anticipated cost of the works?
This represents the total cost or value of the works being carried out on the property and will be added to the building sum insured to accurately reflect the rebuilding cost of the property when works are complete.
£
Please give details
Do you wish to disclose any additional information about the work at this property that you feel may be important to an underwriters assessment of this risk?
Please provide any additional information or further details here
Materials On Site Total
£

Subsidence Questionnaire

Do the Premises (including Outbuildings) have any signs of Damage which may be attributable to subsidence, ground heave or landslip?
Please give details
Are any of the Buildings being monitored for subsidence, ground heave or landslip, or have they ever been monitored for subsidence, ground heave or landslip, or been the subject of subsidence, ground heave or landslip?
Please give details
Have the premises ever been the subject of a survey which mentions settlement or movement of Buildings?
Please give details
Have the premises ever been flooded as a result of broken or damaged underground drains, or are You aware of any extensive underground drainage problems within the last 10 (ten) years?
Please give details
Are there any trees or shrubs (which are more than 10 (ten) feet tall) within 20 (twenty) feet of any Building?
Please give details
Has the structure of the Premises (including Outbuildings) been extended within the last 20 (twenty) years?
Please give details
Has any neighbouring property been subject to any occurrence of subsidence, ground heave or landslip?
Please give details
Have the Premises (including Outbuildings) been subject to any river or coastal erosion?
Please give details

Additional information and declaration

Do you wish to disclose any additional information not specifically asked in the questions that you feel may be important to an underwriters assessment of this risk?
Please provide any additional information or further details here
DECLARATION

Please note the following information, dependent and relevant on whether you are a proposed consumer or business insured :

If you are a consumer insured ( i.e. a person buying insurance wholly or mainly for personal purposes unrelated to your employment ), you have a duty to take reasonable care to answer questions fully and accurately. This duty exists before the cover is placed and throughout the entire duration of the Insurance. If you do not do so, your Insurer may be able to avoid the Policy from inception.

As a Business Insured (i.e. an insured buying insurance wholly or mainly for purpose related to their business).

You have a duty to disclose every material circumstance you know or ought to know, after reasonable search. This applies before the cover is placed, when renewed and if altered at any time during duration of the Policy. A circumstance is material if it would influence an Insurer’s decision whether to accept the risk, including its terms and pricing.

If you are in any doubt whether a circumstance is material to the risk, it should be disclosed, as failure to disclose may entitle your Insurer to either void the Policy from inception or impose different terms. Any claims made would either not be paid or may be reduced in value. Where there are Warranties, Conditions Precedent or any onerous conditions applicable to your insurance policy, failure to meet such conditions could invalidate the cover (and hence no claims would be paid), or suspend cover until such warranty etc, is remedied (and any claims during the suspension period may not be paid).

Cover Details

Claims_1yr_Amount
£
Claims_1yr_Count
£
Claims_2yr_Amount
£
Claims_2yr_Count
£
Claims_3yr_Amount
£
Claims_3yr_Count
£
Claims_4yr_Amount
£
Claims_4yr_Count
£
Claims_5yr_Amount
£
Claims_5yr_Count
£
Set Discretionary Discount @ % £0.00
Set Additional Excess Discount @ % £0.00
Set Claims Discount @ % £0.00
Set Minimum Net Load £ £0.00
Set Discretionary Discount @ % £0.00
Set Additional Excess Discount @ % £0.00
Set Claims Discount @ % £0.00
Set Minimum Net Load £ £0.00

Additional Notes

Additional Notes

Documents Only

Contract Number
Policy Prefix
Broker Address
BrokerPhone
Policy Status (do not change)
1 = First Premium
2 = Adjustment
3 = Renewal
4 = Cancellation
Great Lakes Wording Ref
Broker FCA number to show on docs