Personal Details
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Title:
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Forenames:
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Surname:
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Address:
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Post Code:
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Home Phone Number:
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Email address:
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Occupation:
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Business carried out at home:
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Cover required:
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Standard
Standard and Accidental Damage
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About the property
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Amount of Cover:
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Please specify items that you need covered, along with their replacement costs.
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Business Interuption is included as standard cover at £100,000 with a twelve month indemnity period. If you require higher amounts
please indicate here.
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£10,000 of cover is provided for Accounts Receivable (book debts), if you require a further amount, please indicate here
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Public Liability, standard limit of indemnity is £1,000,000. Please indicate a higher amount if required.
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£2m.
£5m.
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Is the business area within the main building of the home ?
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Yes
No
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If "No" please give details
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Is the home/business area of standard construction (example brick and tiles) ?
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Yes
No
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If "No" please give details
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Do you undertake business away from the home/business ?
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No
Yes
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If "Yes" please give details
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Do you wish to insure the buildings of your home and business area?
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Yes
No
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If "Yes" please indicate the cost of rebuilding your home and business area as new
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