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THE PROPOSER: |
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A) Name |
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B) Title |
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C) Postal Address |
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D) Work Phone |
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E) Home Phone |
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F) E-mail |
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G) Period you require insurance |
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From |
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To |
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CONSTRUCTION INFORMATION |
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A)
Exterior Walls |
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B) Interior Walls |
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C)
Roof |
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D)
Floor |
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SCHEDULE OF PROPERTY TO BE INSURED: |
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A) The Building |
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B) Professional Fees |
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C) Removal of Debris |
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D) On business and office furniture, fixtures and fittings |
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E) All other contents |
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F) Stocks in Trade including goods held in trust |
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G) Total sum required |
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Please note that money, securities, documents, stamps,
manuscripts, business books and computer systems' records are excluded from
contents |
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TRADE OR BUSINESS: |
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A) How are the premises being proposed for insurance being occupied? |
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B) What basis is the business being carried on? |
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C) Is any manufacturing process or repair work carried on within the
premises? |
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If Yes, please specify |
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D) Are flammable liquids stored on the premises? |
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E) Is there any work done on premises that involve the application of heat
process? |
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F) Give details of stocks in trade or any other raw materials are stored |
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G) Will the premises be left unoccupied for more than 30 days? |
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H) Except for the adjoining premises, are there premises in close proximity
which carry on a hazardous trade or occupation? |
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I) Have been any claims on this building? |
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If Yes, give details and amount of claims paid out |
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Brief Details of Cover |
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The policy covers loss or damage caused, by, fire, lightening, explosion of
domestic boilers and explosion of gas for domestic purposes. Premium is related
to the circumstance of each proposal. |
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