commercial proposal form

Step 1 of 9 - Contact

When would you like your Cover to Start?*

Proposers Name*

Mobile Number*

Landline Number

Email*

Main Business Address?*

Start typing your address on the "Street Address line".

Property to be insured

Please Note: Some fields have been populated to make the form quicker to complete. Please amend the pre-selected answer if applicable. Please check your answers to ensure they are accurate.

Has the property previously been or is it currently insured?*

Yes

Previous / Current Insurer?*

Type of Occupants for the property?

Residential

Commercial

Commercial and Residential (mixed)

Property Risk Address*

The address of the property to be insured.

Select type of residential premises?*

Select the mixed property use?*

Select the type of commercial premises?*

In what year were the premises built?*

Listed Building Status?*

Date Property Purchased?*

DD/MM/YYYY

Are there any flats? If so how many flats are in the property?

What Percentage of the Property is unused or unoccupied?*

Is the property used as a House in Multiple Occupation (HMO)?

Yes

Number of floors made of wooden construction?*

Number of floors made of concrete construction?*

Property Occupants / Tenants

Residential Occupant*

Premises Use?*

Rent funded by?*

Commercial Occupant

How many different trades occupy your premises?*

What is the trade of the Commercial Occupants?

2. Additional Trades?

3. Additional Trades?

4. Additional Trades?

5. Additional Trades?

6. Additional Trades?

7. Additional Trades?

8. Additional Trades?

9. Additional Trades?

10.Additional Trades?

If you can't find the correct trade(s) you can manually type them below?

Please enter trade or business of commercial tenant.

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Row ID	Address of Property	Actions
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There are no Another Property.

Declarations

Based on the knowledge of any senior management and anyone involved in arranging the insurance (after making a reasonable search) , has any proposer (as a company or individual including any decision makers involved in how the business’s activities are to be managed or organised), director or partner of the business (or of its subsidiary companies not otherwise excluded), either personally or in any business capacity:

Convictions*

Ever been charged with (but not yet tried) or convicted of any criminal offences excluding motoring offences and offences that are spent under the Rehabilitation of Offenders Act 1974 and subsequent amendments to that Act?

Yes

Bankruptcy*

In the last 5 years been declared bankrupt or been the subject of bankruptcy proceedings, an Administrative Receivership, a Company or Partnership or Individual Voluntary Arrangement, a Debt Relief Order, an Administration Order, a Compulsory Liquidation, a Creditors' Voluntary Liquidation, a Winding Up Order or any equivalents in Scotland or Northern Ireland?

Yes

Adverse insurance history*

In the last 5 years had a policy voided, renewal declined, cancelled where a cancellation clause has been invoked or had special terms imposed by an insurer?

Yes

Have you had any insurance claims in the last 5 years?*

Have you made any insurance claims within the last 5 years whether the claims was paid or declined.

Yes

Please list the claims in the last 5 years.

Date

Claimed Amount

What was the claim for?

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If there is any other information you think we should know about then please enter it below.

Additional Information

Many thanks for completing the form!

Name

This field is for validation purposes and should be left unchanged.

Commercial Property Proposal Form

Your Business

Subsidiary Company

Partnership Companies

Please enter the names of the trustees

Property to be insured

Additional Premises Details

Property Occupants / Tenants

Commercial Occupant

What do you want to Insure?

Buildings Cover Section

Contents Cover Section

Optional Cover

Declarations

Want us to call you?

Commercial Property Proposal Form

Your Business

Subsidiary Company

Partnership Companies

Please enter the names of the trustees

Property to be insured

Additional Premises Details

Property Occupants / Tenants

Commercial Occupant

What do you want to Insure?

Buildings Cover Section

Contents Cover Section

Optional Cover

Declarations

Want us to call you?

Call: 0203 488 4224