Property Owner's Insurance - Quotation Request

Proposer's Name

Contact Name
(if different from above)

E-mail address

Address to be insured

Postcode

Contact Address
(if different from above)

Postcode

Telephone No

Fax No (optional)

About the property

Is the property Commercial or Residential?

select >>> Commercial Residential  

Is the property a holiday home?

  Yes

  No

What cover do you require

select >>> buildings only contents only buildings and contents  

If buildings cover is required, what sum insured?

Is the building...  (please complete even if only insuring contents)

Constructed of brick, stone or concrete and roofed with slates, tiles, concrete, metal or asbestos sheeting?

  Yes

  No

Maintained in a good state of repair?

  Yes

  No

If you have answered no to either of the above, please give details here

About the contents

if you do not require contents cover please click here

Please give the sum insured required for each category 

Category

Sum insured (£)

Landlord's contents

General contents

About the insured

Has the Insured incurred any loss, destruction or damage or had any claim made against them in the last 5 years?

  Yes

  No

if the answer is yes to the above, please provide full details here

Do you require cover for loss of rent?

  Yes

  No

if 'yes' please insert the property's annual rental income

If the property is rented out please state the Tenant's trade

Insurance required from

Renewal Date of present insurance (if applicable)

Preferred Payment Method

choose >>> Credit Card Debit Card Cheque Direct Debit