Insurance Quotation Request Form For Marquee Hirers
       
Company name(*): Telephone:
Contact name(*): Fax:
  Mobile number(*):
Correspondence address: Email(*):
Postcode:    
       
Premises/storage address:    
Postcode:    

   
 
Type of equipment: 
If other please specify :
     
 
How many years have you been trading: years
 
     
 
If none, please detail previous experience in erecting marquees:
 
Please specify
     
 
Maximum span of your marquees:
 
Current Insurer:
 
Current Broker:
 
The Renewal Date of your existing policy:
(dd/mm/yy)
     
  Have you ever been declined a Proposal by Insurers?
  Have you ever had a renewal not invited by Insurers?
  Have you ever had special terms imposed by Insurers?
  Has an Insurer ever refused or cancelled your insurance policy ?
  Have you ever had any criminal convictions?
  Have you ever been declared bankrupt?
 

If you have answered 'Yes' to any of the above please provide further details:

  Have you had any claims, or incidents that would have resulted in a claim if you had had the proposed Insurance, within the last 5 years?
 

If you have answered 'Yes' please provide dates, types of claims and amount paid and reserved by insurers:


 
   
Material Damage
 
Do you require cover for Damage or Loss to your stock? 
Yes
    If you have answered 'Yes' please answer following questions:
 
Are your storage premises of Standard Construction?
Yes
 
Are your premises in your Sole Ocupation?
Yes
     
  If you have answered 'no' to the premises being in your sole occupation, then please give details of persons or businesses that occupy the same premises as you or have access to your premises below and detail their type of business or reason for their access:
 
     
 
Are your premises protected by an intruder alarm?
Yes
  If yes, please specify what type of alarm:  
 
If other, please specify:
 
     
 
Please provide the figures of the covers you wish a quotation for below :
     
  Buildings :
  Contents (Non Computers) :
  Contents (Computers) :
  Tools and Laptops:
  Total replacement value of all of your stock :
   
 
Please confirm whether the firgures given above relate to Reinstatement values (New For Old) or Indemnity values (SecondHand)
 
Reinstatement Indemnity
   
 
Please specify the geographical limits required:
     
 
Would you like to include Goods in Trust on your policy :
Yes
 

If yes, please provide us with the replacement value of the total amount of hired goods you would have at any one time:

 
 
Would you like a quotation for Business Interruption Cover :
Yes
 
Please provide us with your Annual Gross Profit figure:
   
   
Public Liablity
 
Do you require Public Liability Cover? 
Yes
 

If yes, please provide us with your estimated turnover for the next 12 monts.:

 


Please select the indemnity limits you would like a quotation for:

£1m

   
   
Employers Liability
 
Do you require Employers Liability Cover?  
Yes
  If you have answered 'Yes' please provide us with the following:
 
How many full time employees do you have?
 
 
What is your estimated Manual Wage figure for next 12 mths?
 
 
What is your estimated Clerical Wage figure for next 12 mths?
 
     
 
Do you manufacture any goods for sale/repair or own use?  
 

  If you have selected 'Sales' please tell us what percentage of your turnover is reflected by manufacture: %
   
   
   
Health and Safety
 
Do you have a current Health and Safety Policy? 
Yes
 
Do you have a formal Employee Training Programme?
Yes
 
Have you carried out Risk Assessments?
Yes
     
  A quotation is required by (dd/mm/yy)
   
   
  Terms of Business
 

I have read and agree with Terms of Business