Skip to content
Facebook
X
Instagram
YouTube
Search for:
BUSINESS
Start-up Business Insurance
Franchise Insurance
Franchisee Insurance
Franchisor Insurance
Motor Trade Insurance
Vehicle Dealer Insurance
Bodyshop Insurance
Coach Builders Insurance
Vehicle Conversion Specialists Insurance
Camper Van Conversion Business Insurance
Business Vehicle Insurance
Motorcycle Trade Insurance
SMART Repair Insurance
PDR Technician Insurance
Defective Workmanship Insurance
Commercial vehicle Insurance
Fleet Insurance
Van Insurance
Van Fleet Insurance
Contractors
Builders Insurance
Building Contractors Insurance
Scaffolders Insurance
Plastering Contractors Insurance
Electrical Contractors Insurance
Air Conditioning Contractors Insurance
Groundworkers Insurance
JCT 21.2.1Insurance
Painting & Decorating Contractors Insurance
Paving Contractors Insurance
Steel Erectors Insurance
Tradesman insurance
Welders Insurance
Office Insurance
Security
Building Access Control Insurance
CCTV Installer Insurance
Alarm Installer Insurance
Life Sciences Insurance
Cosmetics Business Insurance
Hospitality Insurance
Restaurant Insurance
Takeaway Shop Insurance
Coffee Shop Insurance
Hotel Insurance
Leisure Industry Insurance
Flooring Industry Insurance
Flooring Contractors Insurance
Shop Insurance
Carpet Shop Insurance
Vending Machine Business Insurance
Online Business
Amazon Seller Insurance
Shopify Sellers Insurance
PROPERTY
Block of Flats Insurance
Commercial Building Insurance
Commercial Contents Insurance
Commercial Property Insurance
Land Insurance
Landlord Insurance
Unoccupied Property Insurance
Unoccupied Commercial Property Insurance
Unoccupied Residential Property
MANUFACTURING
Engineering Insurance
Metal Workers and Fabricators Insurance
Laser Cutting Insurance
Metal Finishers Insurance
Plastic Manufacturers Insurance
Vehicle Parts Manufacturers Insurance
Car and Vehicle Accessory Business Insurance
High Risk Liability Insurance
Joinery Business Insurance
Furniture Manufacturers Insurance
Upholsterers Insurance
Window and Door Manufacturers Insurance
Food Product Liability Insurance
Drink Business Insurance
Vitamins & Food Supplements Insurance
Electronics Business Insurance
USA Product Liability Insurance
Printers Insurance
Sign Manufacturers Insurance
INSURANCE TYPES
Liability Insurance
Employers’ Liability Insurance
Public Liability Insurance
Product Liability Insurance
Directors and Officers Liability Insurance
Cyber Insurance
Goods In Transit Insurance
Personal Insurance
Home Buildings and Contents Insurance
ABOUT US
Meet Our Team
About Brown & Brown Insurance Brokers (UK) Limited
News-Real (Blog)
Proposal Forms
USA Product Liability Proposal Form
Vacancies at Real Insurance
Making a Claim
Local
Business Insurance Mansfield
Business Insurance Nottingham
CONTACT
Search for:
BUSINESS
Start-up Business Insurance
Franchise Insurance
Franchisee Insurance
Franchisor Insurance
Motor Trade Insurance
Vehicle Dealer Insurance
Bodyshop Insurance
Coach Builders Insurance
Vehicle Conversion Specialists Insurance
Camper Van Conversion Business Insurance
Business Vehicle Insurance
Motorcycle Trade Insurance
SMART Repair Insurance
PDR Technician Insurance
Defective Workmanship Insurance
Commercial vehicle Insurance
Fleet Insurance
Van Insurance
Van Fleet Insurance
Contractors
Builders Insurance
Building Contractors Insurance
Scaffolders Insurance
Plastering Contractors Insurance
Electrical Contractors Insurance
Air Conditioning Contractors Insurance
Groundworkers Insurance
JCT 21.2.1Insurance
Painting & Decorating Contractors Insurance
Paving Contractors Insurance
Steel Erectors Insurance
Tradesman insurance
Welders Insurance
Office Insurance
Security
Building Access Control Insurance
CCTV Installer Insurance
Alarm Installer Insurance
Life Sciences Insurance
Cosmetics Business Insurance
Hospitality Insurance
Restaurant Insurance
Takeaway Shop Insurance
Coffee Shop Insurance
Hotel Insurance
Leisure Industry Insurance
Flooring Industry Insurance
Flooring Contractors Insurance
Shop Insurance
Carpet Shop Insurance
Vending Machine Business Insurance
Online Business
Amazon Seller Insurance
Shopify Sellers Insurance
PROPERTY
Block of Flats Insurance
Commercial Building Insurance
Commercial Contents Insurance
Commercial Property Insurance
Land Insurance
Landlord Insurance
Unoccupied Property Insurance
Unoccupied Commercial Property Insurance
Unoccupied Residential Property
MANUFACTURING
Engineering Insurance
Metal Workers and Fabricators Insurance
Laser Cutting Insurance
Metal Finishers Insurance
Plastic Manufacturers Insurance
Vehicle Parts Manufacturers Insurance
Car and Vehicle Accessory Business Insurance
High Risk Liability Insurance
Joinery Business Insurance
Furniture Manufacturers Insurance
Upholsterers Insurance
Window and Door Manufacturers Insurance
Food Product Liability Insurance
Drink Business Insurance
Vitamins & Food Supplements Insurance
Electronics Business Insurance
USA Product Liability Insurance
Printers Insurance
Sign Manufacturers Insurance
INSURANCE TYPES
Liability Insurance
Employers’ Liability Insurance
Public Liability Insurance
Product Liability Insurance
Directors and Officers Liability Insurance
Cyber Insurance
Goods In Transit Insurance
Personal Insurance
Home Buildings and Contents Insurance
ABOUT US
Meet Our Team
About Brown & Brown Insurance Brokers (UK) Limited
News-Real (Blog)
Proposal Forms
USA Product Liability Proposal Form
Vacancies at Real Insurance
Making a Claim
Local
Business Insurance Mansfield
Business Insurance Nottingham
CONTACT
BUSINESS
Start-up Business Insurance
Franchise Insurance
Franchisee Insurance
Franchisor Insurance
Motor Trade Insurance
Vehicle Dealer Insurance
Bodyshop Insurance
Coach Builders Insurance
Vehicle Conversion Specialists Insurance
Camper Van Conversion Business Insurance
Business Vehicle Insurance
Motorcycle Trade Insurance
SMART Repair Insurance
PDR Technician Insurance
Defective Workmanship Insurance
Commercial vehicle Insurance
Fleet Insurance
Van Insurance
Van Fleet Insurance
Contractors
Builders Insurance
Building Contractors Insurance
Scaffolders Insurance
Plastering Contractors Insurance
Electrical Contractors Insurance
Air Conditioning Contractors Insurance
Groundworkers Insurance
JCT 21.2.1Insurance
Painting & Decorating Contractors Insurance
Paving Contractors Insurance
Steel Erectors Insurance
Tradesman insurance
Welders Insurance
Office Insurance
Security
Building Access Control Insurance
CCTV Installer Insurance
Alarm Installer Insurance
Life Sciences Insurance
Cosmetics Business Insurance
Hospitality Insurance
Restaurant Insurance
Takeaway Shop Insurance
Coffee Shop Insurance
Hotel Insurance
Leisure Industry Insurance
Flooring Industry Insurance
Flooring Contractors Insurance
Shop Insurance
Carpet Shop Insurance
Vending Machine Business Insurance
Online Business
Amazon Seller Insurance
Shopify Sellers Insurance
PROPERTY
Block of Flats Insurance
Commercial Building Insurance
Commercial Contents Insurance
Commercial Property Insurance
Land Insurance
Landlord Insurance
Unoccupied Property Insurance
Unoccupied Commercial Property Insurance
Unoccupied Residential Property
MANUFACTURING
Engineering Insurance
Metal Workers and Fabricators Insurance
Laser Cutting Insurance
Metal Finishers Insurance
Plastic Manufacturers Insurance
Vehicle Parts Manufacturers Insurance
Car and Vehicle Accessory Business Insurance
High Risk Liability Insurance
Joinery Business Insurance
Furniture Manufacturers Insurance
Upholsterers Insurance
Window and Door Manufacturers Insurance
Food Product Liability Insurance
Drink Business Insurance
Vitamins & Food Supplements Insurance
Electronics Business Insurance
USA Product Liability Insurance
Printers Insurance
Sign Manufacturers Insurance
INSURANCE TYPES
Liability Insurance
Employers’ Liability Insurance
Public Liability Insurance
Product Liability Insurance
Directors and Officers Liability Insurance
Cyber Insurance
Goods In Transit Insurance
Personal Insurance
Home Buildings and Contents Insurance
ABOUT US
Meet Our Team
About Brown & Brown Insurance Brokers (UK) Limited
News-Real (Blog)
Proposal Forms
USA Product Liability Proposal Form
Vacancies at Real Insurance
Making a Claim
Local
Business Insurance Mansfield
Business Insurance Nottingham
CONTACT
Commercial Combined Proposal Form
realinsurance
2020-09-17T14:04:21+01:00
Commercial Combined Proposal Form
Commercial Combined Proposal Form
SECTION 1 - PERSONAL DETAILS
Please complete as much detail as possible. Please note that some fields are mandatory.
Company Name (including subsidaries):
*
Full Postal Address
*
Address to be Insured (if different from above)
Telephone Number
*
Email Address
*
Website Address
*
Date Established
Renewal Date
Full Description of Business Activities
*
Details of any Works undertaken AWAY from Premisis
Details of any Manufactured Products, products sold or supplied
SECTION 2 - SUMS INSURED (BUILDINGS AND CONTENTS)
Please complete as much detail as possible. Please note that some fields are mandatory.
Buildings Sum Insured
Contents Sum Insured (Excluding Items Below)
General Stock
Non-Ferrous Metals
Computers
Electronic Equipment
Cigarettes & Tobacco
Wines and Spirits
Other Target Stock
Any Other Property
SECTION 3 - SECURITY
Please complete as much detail as possible. Please note that some fields are mandatory.
ARE THE PREMISES;
1. In the Sole Occupancy of the Proposer?
*
Yes
No
2. Protected by Intruder Alarm?
*
Yes
No
3. If Alarmed (Yes to Item 2) please confirm method of signalling
4. Protected by water Sprinkler System?
*
Yes
No
SECTION 4 - BUILDINGS/CONSTRUCTION
Please complete as much detail as possible. Please note that some fields are mandatory.
ARE THE PREMISES;
1. Built of Brick, Stone or Concrete
*
Yes
No
2. Roofed with Slates, Tiles, Concrete, Metal or Asbestos
*
Yes
No
3. In a good state of repair and will be maintained
*
Yes
No
4. In an area prone to flooding or where flooding has occuurred
*
Yes
No
5. Please state the method of Heating on the premesis
*
6. Has the electrical systems been checked in the last 5 years by a qualified electrician
*
Yes
No
SECTION 5 - SUBSIDENCE
Please complete as much detail as possible. Please note that some fields are mandatory.
1. Do you require cover for subsidence
*
Yes
No
(a) Has the building ever had any occurrences of subsidence
*
Yes
No
(b) Are there any signs of damage caused by subsidence
*
Yes
No
(c) Any neighbouring property been damaged by subsidence
*
Yes
No
SECTION 6 - LOSS OF INCOME & BOOK DEBT COVER
Please complete as much detail as possible. Please note that some fields are mandatory.
Estimated Gross Profit
Book debts (accounts receivable)
What indemnity period is required
*
12 Months
24 Months
SECTION 7 - PUBLIC AND EMPLOYER LIABILITY COVER
Please complete as much detail as possible. Please note that some fields are mandatory.
Limit of indemnity required
*
£1 Million (GBP)
£2 Million (GBP)
£5 Million (GBP)
Has the firm previously help professional indemnity insurance (if yes, provide details below)
*
Yes
No
Indemnity Limit
Premium
Excess
Expiry Date
SECTION 8 - WAGEROLL
Please complete as much detail as possible. Please note that some fields are mandatory.
Clerical and Managerial
Woodworking Machinists (if applicable)
All other employees at premises
Full Details of work
All other employees away from premises
Full details of work away from premises
Wageroll of
ALL
employees (including partners/directors etc)
Working on premesis
Working away from premesis
Working away from premises and involving use of heat
Payments to subcontractors away from premises
Charges of Plant/Equipment Hire
Annual Turnover
UK
USA/Canada
Other
SECTION 9 - GENERAL
Please complete as much detail as possible. Please note that some fields are mandatory.
Does the work involve:
Any work involved in water-bourne craft, off shore or aircraft operational areas
*
Yes
No
Any work in Power stations, nuclear installations or petrochemical works
*
Yes
No
Any discharge of fumes or anything noxious
*
Yes
No
Do you provide design specification formula or advice in connection with own products
*
Yes
No
Has any Health and Safety notices or prosecution been placed in the last 5 years
*
Yes
No
Do any products form part of any Aircraft, Power Station, Water-bourne craft, off shore installations or petrochemical works
*
Yes
No
Are any Products/Materials imported from outside Europe?
*
Yes
No
Do you have a quality control system in place
*
Yes
No
Do you enter into any contracts or agreements that may affect liability under statue or common law
*
Yes
No
Maximum Height you work to (if applicable)
Maximum Depth you work to (if applicable)
If YES to any of the above section, please provide details at the end of this proposal form
SECTION 10 - OPTIONAL COVERS
Please complete as much detail as possible. Please note that some fields are mandatory.
Please select which optional covers are required:
Goods in Transit
Theft by Employees
Refrigerated Goods
Legal Expense Cover
SECTION 11 - CLAIMS
Please provide any details of any claims, losses or events that could have given rise to a claim whether insured or not, against the proposer for this or any other business (including date, details of incident and costs)
Page load link