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Manufacturers,Wholesalers & Suppliers Insurance Quotation
To help us provide you with out best possible quotation, please complete as much of the following quotation form as you can.
More information about this quotation
Title
Mr
Mrs
Miss
Ms
Dr
Name
Trading Name
Address
Address 2
Address 3
Address 4
Postcode
Telephone
Email
Occupation/Trade
Years Trading
Claims/Losses in the last five years
Age of the building
Is the property a listed building
Not Listed
Grade 1
Grade 2
Construction of walls
Brick
Stone
Other
Type of roof
Slate
Tile
Concrete
Bitumen
Felt on Timber
Other
If flat roof:
Area of flat roof
square meters
Type of flat roof
Please Select
Concrete
Bitumen
Felt on Timber
Other
Type of Alarm
None
Bells Only
Digital Comunicator
Redcare
Do you have 5 lever deadlocks on all final exit doors
Select
Yes
No
If No then please advise the types of lock:-
Do you have window locks on all opening accessible windows
Select
Yes
No
Shutters
None
On Shop Front Only
On All Windows And Doors
Buildings
Tenants Improvements
Business Electronic Equipment
Computer Equipmen (Total)
Other Office Contents
Plant & Machinery
General Stock
Cigarettes & Tobbaco
Wines & Spirits
Frozen Food
Audio Stock
Clothing Stock
Glass
Money
Goods in transit
Business Interuption
Public Liability
£1,000,000
£2,000,000
£5,000,000
Not Required
Employers Liability Required
Required
Not Required
In order to calculate the premiums for the Liability sections we will require the following information
Number of principals / partners (manual work)
Number of principals / partners (non-manual work)
Number of directors (manual work)
Number of directors (non manual work)
Number of employees (manual work)
Number of employees (non manual work)
Number of Labour only Sub-contractors
Projected Annual Turnover
Projected Annual Wages (manual)
Projected Annual Wages (clerical)
Maximum External Height Worked
Meters
Maximum Internal Height Worked
Meters
Any heat application:-
None -
Blowlamps -
Welding -
Gas Cutting
Ever been declared bankrupt or insolvent?
Please Select
Yes
No
Been convicted of any criminal offence, which is not 'Spent'?
Please Select
Yes
No
Had any County Court Judgements entered in the last six years?
Please Select
Yes
No
WestPennine Insurance Services Group is the trading name of WestPennine Insurance Consultants Limited. Registered Office 84 Church Street, Littleborough. OL15 8AU. Registered in England number 939318
Telephone 01706 378990 Fax 01706 371417
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