Client name/trading title:

Date of birth:

Phone number:

Email Address (required)

Home address/correspondence:

Risk Address

Status of entity:

ERN Number:

Trading years:
If new venture, how many years and what previous experience do they have:

Website:

Current Insurer & Price:

Inception date required:

Risk Type:
Risk description:
If sauna/leisure centre: please list facilities:

Any entertainment – what type & how often:

Any performances, if so what type how often?

Any workshops?
If so what happens exactly during these workshops:
Where are they held:
How often:

How many people attend these:

Any door staff:

Any cooking? If so is there any frying?

Is charge made for entry?

Do you sell products online?

What products do you sell:

Do you sell any products outside of the UK? If so, please advise estimated turnover split for
UK


EU


USA

Rest of the world:

Do you import any products from outside of the UK? If so please advise what % of your products are sourced from UK/EU/USA/Rest of the world:

Building construction:
Flat roof % & construction:

Year built:

Listed, if so what grade:

Claim history:
Date:
Type of claim:
What happened:
Measures put in place to avoid this happening again:
Paid/Reserve:

Previous bankruptcy’s/liquidations/CCJ’s:

Alarm Type:

Shutters? Front/Back

CCTV

Manager/staff live on premises?

Number of employees:

PL £2m or £5m?
—Please choose an option—2m5m

Buildings cover:

Tenants improvements:

Trade contents:

BI cover:

BI Stock cover:

Stock cover:

Loss of licence required?

Money in safe:
Money whilst open & in transit:

Turnover:

Wages:
Estimated Wage roll for next 12 months:
Managerial & Clerical Wages:
Manual Wages: (maintenance & cleaning)

Additional information:

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