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The Licenced Trade Inn-surance Specialists

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    • 1

      General Info

    • 2

      Covers Required

    • 3

      Premises Details

    • 4

      Claims History

    • 5

      Duty of Disclosure

    • 6

      Contact Details

    1/6

    General Info

    Start Date:

    Type of Business:

    Business Status:

    Sole Trader Name:
    Trading As:

    Partnership Name:
    Trading As:

    Limited Company Name:
    Trading As:

    Postcode:

    Company:
    Address 1:
    Address 2:
    Address 3:
    Town / City:
    County:

    How many years has the business been trading?

    If 0, please type your experience within the industry:

    0%

    Do you require cover for buildings?

    If yes, building sum insured? £

    Tenant Improvements Sum Insured: £

    Trade Fixtures & Fittings (machinery & plant & all other content excl stock): £

    Wines & Spirits: £

    Stock: £

    Electronic Equipment & Computers: £

    Frozen Foods: £

    Is Loss of Licence required? (£100,000 limit):

    Goods in Transit: £

    Domestic Contents (only available if the proposer lives on site): £

    Public Liability:

    Employees Liability:

    Business Interruption (based on Gross Profit): £

    Indemnity Period For Above:

    Employee Dishonesty Cover:

    Number of Employees:

    What frying equipment is used?

    Number of Covers:

    Scores on the Doors Rating:

    Number of Letting Rooms:

    Is there a late licence after 01:30 in effect?

    If yes, add daily closing times:

    Does the business ever use door security staff?

    If yes, please add times and days and if supplied by a third party SIA approved company with their own insurance:

    Any open fires or solid fuel burners?

    Any child play areas?

    Please describe what equipment you have:

    20%

    Is any of the roof flat?

    Flat roof % of overall:
    Construction of Flat Roof:

    When was the building built?

    If Pre 1700, approx age:

    Is the building listed?

    Is the property occupied by the proposer, or their employees overnight?

    Is there an intruder alarm?

    If yes, what type of alarm is fitted?

    Is the alarm maintained by a NACOSS or SSAIB company?

    Is there CCTV at the premises?

    Does the CCTV record?

    How many days does it record for?

    40%

    Date:

    Type of Claim:

    If Other, please describe:

    Paid: £

    Reserve: £

    Measures taken:

    60%

    Buildings/Premises

    The Premises are self-contained with their own means of access:

    The Premises are not in an area with a history of flooding:

    The Premises are not in an area with a history of subsidence, heave and/or landslip:

    There are no ATMs (cash machines) on the Premises:

    The Business Premises / Buildings of the Business has walls built of brick, stone, concrete or incombustible materials and has a roof of slate, tile, metal, concrete or incombustible materials (excluding any flat roof area):

    The Business Premises / Buildings of the Business are in a good state of repair and kept in a like manner:

    Insurance History

    No proposer, director or partner of the Business has ever:

    had an insurance contract cancelled, declared void, renewal refused or had special terms imposed by an insurer

    had different terms applied to an insurance contract by an insurer due to misrepresentation by providing misleading or incorrect information, deliberately or recklessly withholding information and/or providing false documents:

    had insurance cover restricted or cancelled due to non-compliance with risk improvement requirements:

    Convictions

    No proposer, director or partner of the Business has:

    unspent convictions, criminal offences, or prosecutions pending other than motoring offences? Spent convictions (as defined under the Rehabilitation of Offenders Act 1974 or any similar or subsequent legislation) do not need to be declared.

    Bankruptcy/Insolvency

    No proposer, director or partner of the Business has:

    been declared bankrupt/insolvent or been the subject of bankruptcy or insolvency proceedings, been the subject of County Court Judgements (or Scottish equivalent), involved in a company that has gone into voluntary or involuntary insolvency or entered into an individual voluntary agreement with creditors, either as a private individual or in connection with any business, and/or been disqualified from holding a directorship.

    Health & Safety

    No proposer, director or partner of the Business has ever:

    been convicted of (or charged but not yet tried) with a breach of any UK Health & Safety legislation by any official regulatory authority or enforcing authority.

    been served with a prohibition notice or improvement notice in connection with any UK Health & Safety legislation by any official regulatory body or enforcing authority.

    been served with a clean-up notice in connection with UK Health & Safety legislation by an official regulatory body or enforcing authority.

    Legal Expenses Insurance

    No proposer, director or partner of the Business has:

    had more than one dispute or legal proceeding(s) to which this Legal Expenses Insurance would apply during the last 3 years and/or has been subject to any dispute or legal proceedings to which Legal Expenses Insurance would apply which has incurred costs in excess of £5,000 in the last 5 years

    more than 10 properties and/or leases to which Legal Expenses Insurance would apply.

    80%

    Current Insurer:

    Attach Current Policy Documents:
    Attach Current Policy Documents:
    Attach Current Policy Documents:
    Attach Current Policy Documents:
    Attach Current Policy Documents:

    CONTACT DETAILS

    Email Address:

    Contact Number:

    Contact Name:

    100%