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.



  • SECTION 2 - SUMS INSURED (BUILDINGS AND CONTENTS)

    Please complete as much detail as possible. Please note that some fields are mandatory.



  • SECTION 3 - SECURITY

    Please complete as much detail as possible. Please note that some fields are mandatory.

    ARE THE PREMISES;



  • SECTION 4 - BUILDINGS/CONSTRUCTION

    Please complete as much detail as possible. Please note that some fields are mandatory.

    ARE THE PREMISES;



  • SECTION 5 - SUBSIDENCE

    Please complete as much detail as possible. Please note that some fields are mandatory.



  • SECTION 6 - LOSS OF INCOME & BOOK DEBT COVER

    Please complete as much detail as possible. Please note that some fields are mandatory.



  • SECTION 7 - PUBLIC AND EMPLOYER LIABILITY COVER

    Please complete as much detail as possible. Please note that some fields are mandatory.



  • SECTION 8 - WAGEROLL

    Please complete as much detail as possible. Please note that some fields are mandatory.

  • Wageroll of ALL employees (including partners/directors etc)
  • Annual Turnover


  • SECTION 9 - GENERAL

    Please complete as much detail as possible. Please note that some fields are mandatory.

    Does the work involve:

  • 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:



  • SECTION 11 - CLAIMS