Household quotation request
Personal details
  1. Fields marked * are required.
  2. Please insert the reference code found in the red box on the reverse of the leaflet e.g Leaflet 1
Building – Construction
  1. What type of building is to be covered?
  2. Is the building to be of standard construction?
  3. Does the Building have any flat roofs?
  4. Please give the age of the flat roof, how much of the total area is flat and when it was last replaced.
  5. What year was the property built?
  6. Has the property suffered from flooding?
  7. If YES, please give details.
  8. Has the property ever suffered from subsidence?
Building – Private Residence
  1. Do you live above the shop?
  2. Is there an internal door connecting your shop & your private residence?
  3. Do you own the building?
  4. If NO, do you rent it out from a Landlord?
  5. Do you rent it …
  6. Do you live in or let out the property?
  7. Is the property regularly left unoccupied (without an adult in the house), for example during the day/night/weekend?
  8. Is the property ever left unoccupied for more than 30 consecutive days at a time?
  9. Is the property a holiday or 2nd home?
  10. Any part of the property used for business purposes?
  11. Do you require buildings cover?
  12. What would be the rebuilding cost of the building?
    £
  13. Do you require contents cover?
  14. If yes, what is the total value of contents you require covered?
    £
  15. Do you require cover for accidental damage to contents?
  16. Is there a safe at the property?
  17. Any items which have a value of £1500.00 or more?
  18. If YES, please give details of each item, including age, approximate cost of repair or replacement.
  19. Do you have any coin collections at this property?
  20. Do you have any stamp collections at this property?
  21. £150.00 of frozen food cover is already included, do you want to increase this to £250.00?
  22. Does the property have an intruder alarm system?
  23. Does it have a maintenance contract with an approval NSI/SSAIB company?
  24. Is the property in a neighbourhood watch area?
  25. Are all the final entrance/exit doors secured with at least one five lever mortice lock deadlock?
  26. Are all the ground floor windows and other windows easily accessible from the ground floor fitted with window locks?
  27. Have you or anyone permanently residing at the property had any claims for items or event covered un this insurance in the last five years?
  28. If YES, please give details of refusal/withdrawn cover.
  29. Have you or anyone permanently residing at the property ever been convicted of any offence (other than motoring)
  30. If YES, please give details.
Thank you for contacting us!
We will come back to you as soon as possible.