Client Details

Start Date*

What is the Business Status?*
—Sole TraderPartnershipLimited CompanyNon Limited CompanyCharity OrganisationLimited Liability Partnership

Limited Company Name*
if applicable

Proposer Name &/or Business Trading Name?*

Please provide an email address*

What best describes the Business?*
—BarGastro-PubMirco-BreweryPublic HouseRestaurant

What is the Risk Address

How many years has the Business been trading?*

Is there any Third Party interest to be noted?*
YesNo

Please Explain*

Cover Details

Do you require cover for Buildings?*
YesNo

Building Sum Insured*
Including Subsidence and Landlords Fixtures and Fittings

Tenants Improvements Sum Insured*
Including external signs, canopies, awnings, ETC. For which the insured is held legally responsible for

Trading Fixtures & Fittings, Machinery, Plants and all Other Contents (Ex. Stock in Trade)*
Including Property Held in Trust

Stock Sum Insured*
Including Materials in Trade, the Property of the Insured or held in trust or commission for which the Insured is held legally responsible

Electronic Equipment & Computers Sum Insured*

Deterioration of Stock*
Cover for frozen food ETC.

Wines & Spirits*

Is loss of License cover required? (£100,000 Limit)*
YesNo

Goods in Transit*

Money During Business Hours and In Transit?*

Money in Locked Safe outside Business Hours*

Is Domestic Contents cover required?*
Only available if the Proposer lives on/at the risk premises
YesNo

Do you require cover for Business Interruption?*
YesNo

Do you require cover for Public and Products Liability?*
YesNo

Do you require Employer’s Liability (£10m Limit)*
YesNo

Do you require Equipment Breakdown cover?*
Cover for Equipment loss, destruction or damage in the event of an Accident at the Premises Covered
YesNo

Do you require Employee Dishonesty cover? (£5,000 Limit)*
Cover for direct financial loss as a direct result of thief by an Employee which is Discovered within 72 hours of the thief occurring.
YesNo

Pub/Bar Details

Number of employees?*
If you are requesting a 3 month policy then please only include the number of employees for the period. Include all directors, partners, part time, junior staff and volunteers.

Does the Business use any frying equipment on the premises? If yes, please advise what type of fryer is used?*
—Basket FryerFree Standing FryerFull RangeNoPan FryerTable Top Fryer

How many rooms do you let out?

Is there a Late Licence (after 01:30) in effect?*
YesNo

Does the Premises have any Open Fires*
YesNo

Premises Construction

Is there an area of flat roof at the premises?
YesNo

When was the building built?*
—Pre 17001701 – 18001801 – 19001901 – 19501951 – Present

Is the building listed?*
YesNo

What type of location is the Business Premises in?*
—ArcadeBusiness ParkCovered Shopping CentreDomestic PremisesHigh StreetIn Building Otherwise Occupied as DwellingsOffice PremisesIndustrial UnitMarketMarket HallParade

Is the Premises occupied by the proposer, or their employees overnight?*
YesNo

Premises Security

Are the premises thoroughly protected by an intruder alarm system, under the sole control of the insured?*
YesNo

Is there CCTV on the premises?*
—NoInternalExternalInternal and External

Is the CCTV recorded?*
YesNo

Claims History

Has the Proposer(s), Partner(s) or Director(s) suffered a loss, claim or incident (which may give rise to a claim) at these premises, any other premises, or which may be covered under a legal expenses insurance policy, whether insured or not within the last 5 years?*
YesNo

Please provide the date of loss. What happened? If the claim was successful what was paid out? Please also provide details of measured that have been taken to avoid a similar claim.

Please READ the following assumptions very carefully and ensure that all the information provided by the Proposer is correct

I have read and Agree/Disagree to all information is the following. Please find the file here.*
AgreeDisagree

Please explain why?*

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