Office Insurance Inquiry Form 7 GET A QUOTATION FOR OFFICE INSURANCE Step 1 of 5 20% OFFICE INSURANCE - CLIENT DETAILSProposer* Risk Address* The Glasshouses GH1 The glasshouses GH2 Business Established* Risk Contact Email* Contact Phone Number*Business Description*Detail any Claims* PROPERTY INSURANCEHiddenBuildings - Sum To Be Insured*HiddenContents, Fixtures & Fittings, Tenants Improvements - Sum To Be Insured*HiddenFire Brigade Charges - Sum To Be Insured*Money in Transit or in Safe - Sum To Be Insured*Customers Goods - Sum To Be Insured*Items away from the premises - Sum To Be Insured*Smart Phones / Tablets - Sum To Be Insured*Computers (excl. Laptops) - Sum To Be Insured*Laptops - Sum To Be Insured*Property in the open - Sum To Be Insured*Employees personal effects / equipment - Sum To Be Insured*HiddenTemporary buildings or contents therein (eg. portacabin) - Sum To Be Insured*Goods in Transit - Sum To Be Insured*Please advise if Subsidence &/or Terrorism is required* BUSINESS INTERRUPTIONGross Revenue / Fees - Sum To Be Insured*Increased Cost of Working- Sum To Be Insured*Indemnity Period required (eg. 12 / 24 / 36 months)* EMPLOYERS LIABILITY - Type of EmployeesClerical*Clerical Projected Wages*Manual*Manual Projected Wages*Work Away*Work Away Projected Wages*Working Directors (if cover required)*Working Directors Projected Wages*Other*Other Projected Wages* PUBLIC / PRODUCTS LIABILITYLimit of Indemnity? (eg. € 2.6m or € 6.5m)*Estimated Turnover*Is there any Work Away from premises carried out? Please advise if Professional Indemnity &/or Directors & Officers is required* HiddenIs there an Intruder Alarm operative? YES NO HiddenIs this alarm linked to monitoring station? YES NO HiddenIs there a Fire Alarm operative? YES NO HiddenIs this alarm linked to monitoring station? YES NO HiddenAre there Fire Extinguishers installed? YES NO HiddenIs there good physical security (eg. 5 lever mortice deadlocks) YES NO HiddenIs there CCTV cameras in operation YES NO HiddenIs the buildings of standard construction and in good physical condition (example: built entirely of non combustible materials, fitted with modern electrics, free from flood, no flat roof) YES NO HiddenWalls ? (eg. concrete, brick, metal cladding)* HiddenRoof ? (eg. slate, concrete, asbestos, mineral felt, asphalt)* HiddenFloors ? (eg. concrete, timber)* HiddenAge of Building ?* HiddenType of heating?* HiddenAge of Electrics* HiddenAny non standard features? (eg. flat roof, timber frame)* This document is purely for the purposes of obtaining an indicative quotation on your behalf. It does not replace a proposal form and the details declared do not in any manner form part of any future contract you may bind with an Underwriter. All material facts must be disclosed otherwise it might invalidate the cover. If you are unsure what a material fact is please contact us for clarification Please advise if any Insurer or Underwriter ever declined cancelled or withdrawn cover, refused to renew or imposed special terms on any insurance policy.*Please advise if you or any of your Partners or Directors have ever been convicted/charged but not yet tried with a criminal offence other than a motoring offence &/or ever been declared bankrupt &/or are subject of any current bankruptcy proceedings.*I consent to The Glasshouses to collect, store and forward my personal information to insurance partners in order to provide me with a office insurance quotation.* YES We'll treat the information you provide with respect. Please refer to our Privacy Policy for more information. By Submitting this form you agree that we may process your information in accordance with these terms.CAPTCHA
