Trade Quotation

Business Insurance Quotation

Please fill out the required information as accurately as possible to help us provide you with the best possible cover available.

(*) denotes required field

Your Details

*

*

Company Details

*

*

*

*

Your Details

*

Your Details

Nature of Business*

Are you a new business?YesNo

Are you a limited company?YesNo

Please fill give us the number of Directors, employees & subcontractors below as applicable:

Current Premium Band

Employers Liability Required?YesNo

Public Liability Limit Required

Your Details

Declaration Statements

Has any Principal, Partner or Director in the business ever been prosecuted under any safety legislation during the last 5 years or have any such notices pending?*

YesNo

Has any Principal, Partner or Director in the business ever been convicted of or charged (but not yet tried) with any criminal offence other than motoring offences? *

YesNo

Has the business, or any Director or Partner of this business – in relation to this business, in relation to any other business or in a personal capacity – been declared bankrupt or insolvent or been a Director of a company or organisation that has gone into liquidation, administration or receivership?*

YesNo

Has any Principal, Partner or Director in the business ever had a proposal for insurance refused or declined or ever had an insurance cancelled, renewal refused or had special terms imposed?*

YesNo

Does the business involve:

- Handling or use of silica, asbestos or substances containing asbestos, acids (other than brick acid), gases, explosives, radioactive or similar dangerous liquids or substances?*

YesNo

- Demolition or partial demolition? *

YesNo

- Any offshore work?*

YesNo

- Work in Hazardous Locations such as: docks, harbours, railways, watercraft, or offshore gas or oil installations, chemical or petrochemical works, oil or gas refineries or storage facilities, aircraft, airports or airfields, power stations, nuclear power stations, or any installation where nuclear processing is undertaken, towers, steeples, chimney shafts, blast furnaces, viaducts, bridges, flyovers, dams, reservoirs, motorways, quarries, mines, collieries or tunnels *

YesNo

Please tick to accept & agree to our terms & conditions*