ABOUT
YOU
Your
name
Mr
Mrs
Miss
Ms
Other
:
First name .....................Surname
If you are acting for the owner, advise their name
Please select
Mr
Mrs
Miss
Ms
Exors of
Other
:
First name .....................Surname
Your business name, if any:
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)
Owner's occupation (aside
from property owner):
Owner's date of birth
ABOUT
THE PROPERTY TO INSURE
Address
line 1:
Address
line 2:
Town
or City:
Postcode:
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
Is the property undergoing renovations?
No
Redecorating only
Modernisation-no structural
Modernisation including structural
Conversion to flats
Commercial to residential
Residential to commercial
Barn conversion
Other
How long do you estimate the works will take?
Please select
Under 3 months
Between 3 - 6 months
Between 6 - 12 months
Over 12 months
How much do you estimate the works will cost?
Please select
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
Please describe what type of renovations are being undertaken
How
many bedrooms does the property have?
Please select
1
2
3
4
5
6 or more
How many flats are there?
Select if required
1
2
3
4
5
6
7 or more
Please describe what type of business is run from the property.
How
is the property currently occupied?
Please select
By a family member
By a business (please advise type below)
Asylum Seekers
Bedsits
DSS / Not working
Empty - awaiting tenants
Empty - awaiting sale
Empty - awaiting renovations
Holiday
Students
Working family
Other (please advise below)
How long has the property been empty for?
Please select
Under 6 months
6 - 12 months
Over a year
When will it be occupied?
Please select
Within 7 days
Within 30 days
Within 60 days
Within 90 days
Over 90 days
Unknown
Will it be inspected every 2 weeks?
Yes
No
Has the letterbox been sealed?
Yes
No
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?
Do
you have 5 lever mortise deadlocks on all final exit
doors and key operated locks on all windows.
No
Yes
Double-glazed
doors with multi-point locking are also acceptable
Has
the area ever been flooded?
No
Yes - further details below
Have you had any claims in the past 5 years?
No Yes
Please advise the date, what happened and how much was paid out
ABOUT
THE COVER YOU REQUIRE
Please
advise the re-building cost
£
Click here for a calculator
Which year
was the building built?
Is it a "listed" property
No
Grade I
Grade II*
Grade II
Grade A
Grade B
Grade B+
Grade B1
Grade C
Is subsidence
cover required?
No
Yes and there are no subsidence problems
Not available if the property or
surrounding area has been affected by subsidence, landslip,
heave or settlement
If
rent cover is required, how much rent will you
collect during the next 12 months?
£
Leave blank if not required
CONTENTS AND OTHER OPTIONAL COVER
Do you want to insure the contents of the building?
No
Yes
Value
of furnishings and appliances
£ Leave blank if not required
Communal
areas
£ Leave blank if not required
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.
How much
excess would you prefer?
£50
£100
£250
£500
£1,000
£5,000
£10,000
How long do you require insurance for?
12 months
273 days
182 days
90 days
If
there is anything we have failed to ask but could
affect your quotation?
Lastly! Please advise the
name of your current insurers and
best quote so far.
