PUBLIC LIABILITY INSURANCE QUOTE FORM

ABOUT YOUR BUSINESS

Your Name (required)

Your Company Or Trading Name (if applicable)

Your Address & Postcode (required)

Business Activity, Trade or Profession (required)

Premises Worked On? e.g. Commercial, Domestic, Home etc

Date You Started Trading? (required)

LIABILITY & WAGE ROLL

Estimated Gross Turnover For The Year

Amount Of Public Liability Required
£1,000,000£2,000,000£5,000,000£10,000,000Not Sure

Amount Of Products Liability If Required
£1,000,000£2,000,000£5,000,000£10,000,000Not Sure

Amount Of Professional Indemnity If Required
£1,000,000£2,000,000£5,000,000£10,000,000Not Sure

Employer's Liability Required? (£10,000,000)
YesNoNot Sure

Number Of Directors,Principals Employed Doing Manual Work

Amount Paid In Wages To Directors,Principals Employed Doing Manual Work

Number Of Directors/Principals Employed Doing Clerical Work

Amount Paid In Wages To Directors,Principals Employed Doing Clerical Work

Number Of Employees Doing Manual Work

Amount Paid In Wages To Employees Doing Manual Work

Number Of Employees Doing Clerical Work

Amount Paid In Wages To Employees Doing Clerical Work

Do You Use Bona-Fide Sub Contractors
YesNo

Amount Paid In Wages To Bona-Fide Sub Contractors

TOOLS COVER

Do You Require Tools Cover? If Yes Please Enter Amount Required

Cover Required For Tools Left In Un-garaged Vehicle Overnight?
YesNo

PLANT COVER

Do You Require Own Plant Cover? If Yes Please Enter Amount Required

Do You Require Hired In Plant Cover? If Yes Please Enter Amount Required

HEAT WORK

Do Any of Your Processes Require The Use Of Heat? If Yes Please Check The Boxes
Blow-LampsBlow-TorchesHot-Air-GunsWelding-EquipmentFlame-Cutting-EquipmentOther

Any Claims In Last 5 Years
YesNo

Your Email (required)

Contact Telephone Number (required)

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