property insuance quotation

Applicant 1 Name

Email Address

Daytime Telephone Number

Date of Birth

Occupation

House number/house name

Postcode

Applicant 2 Name

Date of Birth

Occupation

Have you, or anyone to be insured, sustained any loss or damage, whether claimed for or not, in the last five years

Total number of occupants in the property under 18 years old

Have you, or any person living in the home, been convicted of or received a police caution for any criminal offence (not motoring offence) or have any prosecution pending?

Have you, or any person living in the home, ever had an insurance policy cancelled, been refused insurance or had special terms imposed?

If you have answered yes to any of the above questions please give details here.

Buildings cover required

Cover required

Buildings Excess

Buildings Sum Insured

Year of Purchase

Buildings years claim-free

Contents cover required

Contents sum insured

Cover required

Contents Excess

Contents years claim free

Amount of Valuables included within the contents sum insured above

Please list any valuables, gold, silver or other precious metals, jewellery, furs, pictures or other works of art, collections of stamps or coins which exceed £1000 in value. Do not include any article insured separately under Personal Possessions

Year property was built

Description of the home

If the property is a flat, on which floor is it situated

Is the property a listed building and if so what Grade

Number of bedrooms

Number of bathrooms

Are the buildings and outbuildings of standard construction, i.e. built of brick, stone or concrete and roofed with slate or tiles

Are the buildings and outbuildings in a good state of repair and regularly maintained

Are the buildings and/or outbuildings free from any signs of subsidence, landslip and heave, e.g. diagonal cracking either internal or external

Are the buildings and/or outbuildings free from any previous subsidence, movement or underpinning whether current or historic

Are the buildings and/or outbuildings free from, and in an area historically free from flooding

Are the buildings and/or outbuildings more than 200 metres (650 feet) away from any rivers, streams, other watercourses or tidal waters

Are the buildings and/or outbuildings free from any planned or ongoing works, refurbishments or renovations

If you have answered No to any of the above questions please provide details

Is the risk address occupied or used as anything other than your main residence

Is the risk address occupied by anyone other than your family e.g. lodgers or tenants

Are the buildings and/or outbuildings used for business or professional purposes

Is the property ever left unoccupied for more than 60 consecutive days at a time

Are you in receipt of any rental/letting income from the property?

If you have answered YES to any of the above questions please provide details

Are all external doors fitted with locks conforming to BS3621

Are all accessible windows fitted with key-operated locks or sash stops

Are all French/patio doors fitted with key-operated bolts top and bottom

If you have answered No to any of the above questions please provide details

Is the property fitted with an intruder alarm system

If so which type

Is there an annual maintenance contract in place?

Property Insurance Quotation