Property Owners quotation form:
Full name of proposer (please show all names of companies to be insured including all subsidiaries; if not a limited company, full names of all partners)
Insured and or trading name:
Contact Name:
company registration number: Telephone Number:
Postal Address: Email:
Fax Number:
Postcode: Website address:
Risk Details:
Risk Address 1: Please tick appropriate occupancy:

Full time employment

student
D.S.S
unoccupied
Other
Postcode:    
Sums Insured:
Buildings:
Landlords contents:
Rent receivable:
Is the property to be insured
constructed of brick, stone or concrete?
Yes
No (Provide Details)
And roofed soley with slate tile or concrete: Yes
No (Provide details)
Details:
Is any part of the roof flat felt and bitumen roofing: Yes
No
If yes what is the total area covered:
What is the age of the property:
Full description of trade or business carried out in the risk premises
Risk Address 2:
Risk Address 2: Please tick appropriate occupancy:

Full time employment

student
D.S.S
unoccupied
Other
Postcode:    
Sums Insured:
Buildings:
Landlords contents:
Rent receivable:
Is the property to be insured
constructed of brick, stone or concrete?
And roofed soley with slate tile or concrete: Yes
No
Is any part of the roof flat felt and bitumen roofing: Yes
No
If yes what is the total area covered:
What is the age of the property:
Full description of trade or business carried out in the risk premises
Risk Address 3:
Risk Address 3: Please tick appropriate occupancy:

Full time employment

student
D.S.S
unoccupied
Other
Postcode:    
Sums Insured:
Buildings:
Landlords contents:
Rent receivable:
Is the property to be insured
constructed of brick, stone or concrete?
And roofed soley with slate tile or concrete: Yes
No
Is any part of the roof flat felt and bitumen roofing: Yes
No
If yes what is the total area covered:
What is the age of the property:
Full description of trade or business carried out in the risk premises
Risk Address 4:
Risk Address 4: Please tick appropriate occupancy:

Full time employment

student
D.S.S
unoccupied
Other
Postcode:    
Sums Insured:
Buildings:
Landlords contents:
Rent receivable:
Is the property to be insured
constructed of brick, stone or concrete?
And roofed soley with slate tile or concrete: Yes
No
Is any part of the roof flat felt and bitumen roofing: Yes
No
If yes what is the total area covered:
What is the age of the property:
Full description of trade or business carried out in the risk premises
Risk Address 5:
Risk Address 5: Please tick appropriate occupancy:

Full time employment

student
D.S.S
unoccupied
Other
Postcode:    
Sums Insured:
Buildings:
Landlords contents:
Rent receivable:
Is the property to be insured
constructed of brick, stone or concrete?
And roofed soley with slate tile or concrete: Yes
No
Is any part of the roof flat felt and bitumen roofing: Yes
No
If yes what is the total area covered:
What is the age of the property:
Full description of trade or business carried out in the risk premises
Risk Address 6:
Risk Address 6: Please tick appropriate occupancy:

Full time employment

student
D.S.S
unoccupied
Other
Postcode:    
Sums Insured:
Buildings:
Landlords contents:
Rent receivable:
Is the property to be insured
constructed of brick, stone or concrete?
And roofed soley with slate tile or concrete: Yes
No
Is any part of the roof flat felt and bitumen roofing: Yes
No
If yes what is the total area covered:
What is the age of the property:
Full description of trade or business carried out in the risk premises

Please note the above information will be used to obtain an indication of the premium required. It may be nessecary to obtain further details in order to confirm the premium and any conditions applying to the cover.