Full name:
Full business name / trading name:
Business correspondence address:
Business correspondence postcode:
Contact telephone number:
Contact email address:
Have you made any indemnity or liability claims in the past 5 years or have incidents that could lead to a claim:
Please supply details of the incident/loss, date of the incident/loss, is this now settled, total claim payout, any preventative measures input to prevent further loss:
Have you had any previous CCJ’s, Bankruptcy, or director of liquidated companies personally or in a company name (this applies to all directors if in a company name):
Please supply further details:
Have you had any insurance declined, terminated, refused or special terms imposed
Please supply further details:
Have you had any criminal convictions other than motoring:
Please supply further details:
How did you hear about us:
Year business established:
Please confirm current insurer:
What is the renewal date of your policy:
Please confirm all business activities:
How many years experience do you have in this trade:
Do you have a separate dedicated business premises?:
Please supply further details:
Does your work involve discharge of fumes, effluent or anything to a noxious nature?:
Please supply further details:
Does your work involve the use of substances which could be harmful to health?:
Please supply further details:
Please confirm the maximum height you work to in metres:
Please confirm the maximum depth you work to in metres:
Do you undertake any piling work, underpinning or basement work?:
Please supply further details:
Do you carry out work involving demolition unless such work forms part of a contract undertaken by you for rebuilding, alteration, maintenance or repair?:
Please supply further details:
Do you carry out work involving the removal, mining, processing, manufacturing, distribution, storage, disposal, sampling, treatment, maintenance or repair of asbestos or products made entirely of asbestos?:
Please supply further details:
Please confirm your annual turnover::
Please confirm number of manual employees on PAYE:
Please confirm annual wages for these employees:
Please confirm number of Clerical employees on PAYE:
Please confirm annual wages for these employees:
Please confirm number of manual employees which are labour only subcontractors:
Please confirm annual wages for these employees:
Labour-Only Subcontractors (LOSCs)
Essentially treated like employees Work under the direct control and supervision of the contractor
Use the contractor’s tools, equipment, and materials
Paid hourly, weekly, or daily rather than per project
Covered under the contractor’s Employers’ Liability (EL) and Public Liability (PL) insurance
The contractor is responsible for their tax and National Insurance contributions
Bona Fide Subcontractors (BFSCs)
Operate as independent businesses Provide their own tools, equipment, and materials
Work under their own direction, without being directly supervised by the contractor
Paid per project or job rather than hourly
Expected to hold their own Public Liability (PL) insurance (and Employers' Liability if they have staff)
Responsible for their own tax and National Insurance
What level of public liability do you require?:
£1,000,000
£5,000,000
£10,000,000
Do you require Contractors All Risks cover?:
Maximum value of any one contract:
Do you require cover for Own Plant?:
Total market value of all plant items:
Maximum value of any one item:
Do you require cover for Hired Plant?:
Total market value of all plant items:
Maximum value of any one item:
Annual hiring charges:
Please specify the amount:
All doors and windows and other points of access have been closed and locked and any security devices correctly set to operate and all keys to doors ignition and other services removed and the insured property is hidden from view.
Such vehicle is in a securely locked building or a vehicle park permanently attended by security personnel between the hours of 9.00pm and 6.00am (c) whilst left Unattended during the working day or overnight or at weekends or other non-working days.
On any site or premises where You or any Employee is carrying out work unless stored in a securely locked room, building, container or receptacle which must be retained within a locked compound or yard incorporating enclosed perimeter walls or fencing and padlocked points of access.
Elsewhere unless stored in a securely locked room building, container or receptacle which must be retained within a locked compound or yard incorporating enclosed perimeter walls or fencing and padlocked points of access.
If you require cover for tools and your vehicle is NOT kept in a locked compound overnight then please specify?:
Do you require Business Legal Expenses?:
Do you require Professional Indemnity Insurance?:
Please confirm limit:
£100k
£250k
£500k
£1 Million
£1.5 Million
£2 Million
Other
Please specify amount required:
Turnover where the firm carries out construction/installation based on designs drawn up by the firm:
Turnover where the firm carries out construction/installation based on designs drawn up by third parties appointed by the firm:
Turnover where the firm carries out construction/installation based on designs drawn up by third parties appointed not by the firm:
Fees for design only (i.e. no construction element):
Fees for supervisory work only (i.e. no design or construction element):
All other turnover:
What proportion of your work is "Aborted work" as a percentage:
What proportion of your work is "Architecture - New build/structural refurbishment" as a percentage:
What proportion of your work is "Architecture - Non-structural refurbishment" as a percentage:
What proportion of your work is "Building surveys non-structural / land surveys" as a percentage:
What proportion of your work is "Civil engineering" as a percentage:
What proportion of your work is "Electrical engineering" as a percentage:
What proportion of your work is "Feasibility studies/expert witness work" as a percentage:
What proportion of your work is "Heating and ventilation engineering" as a percentage:
What proportion of your work is "Interior design" as a percentage:
What proportion of your work is "Landscape / garden architecture" as a percentage:
What proportion of your work is "Mechanical engineering" as a percentage:
What proportion of your work is "Planning supervisory / CDM activities" as a percentage:
What proportion of your work is "Project co-ordination" as a percentage:
What proportion of your work is "Project management" as a percentage:
What proportion of your work is "Quality surveying" as a percentage:
What proportion of your work is "Soil & foundation engineering" as a percentage:
What proportion of your work is "Structural engineering" as a percentage:
What proportion of your work is "Structural surveys/valuations" as a percentage:
What proportion of your work is "Town planning" as a percentage:
What proportion of your work is "Other" as a percentage:
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