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01784 436 262

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13 Station Road
Egham
TW20 9LD

 

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Quotation Request for Hotels/Inns/Guest Houses/ B&B

In order for us to provide you with the best quote please ensure all questions are fully answered.

EMAIL ADDRESS *

TELEPHONE *

MOBILE

INCEPTION DATE *  dd/mm/yyyy

HOW DID YOU HEAR ABOUT US Yell.com Google MSN Yahoo Leaflet Word of Mouth Existing Customer Yellow Pages Other

PROPOSER DETAILS

TITLE Mr Mrs Miss Ms

FULL NAME *

COMPANY NAME

TYPE OF COMPANY Sole Trader Limited Company Partnership

PRIMARY TRADE Accountant Actuary Adult Products Retailer Advertising Agent / Consultant Arts and Crafts Retailer Astrologer / Astronomer Auditor Baby Goods and Equipment Retailer Baker (Sales only) Barber Bathroom Showroom Beauty Therapy Salon Bed and Breakfast Bedroom Showroom Bicycle Retailer Book / Magazine Retailer Bookmaker Bridalwear Retailer Butcher ( no cooking ) Butcher (with less than 10% baking / boiling) Cafe (Including Deep Fat Frying) Camping Equipment Retailer Carpet Retailer CD/DVD Retailer Ceramic Tile Retailer Chemist China and Glass Retailer Clothing Retailer (Children/Schoolwear) Clothing Retailer (Designer Wear) Clothing Retailer (not `Designer` clothes) Coffee Shop Coin / Medal / Stamp Dealer Commercial Artist Computer Retailer Confectioner Conveyancer Curtain and Blind Retailers D I Y Consumables Retailer D I Y Equipment Retailer Dance Equipment Retailer Delicatessen Designer Clothing Retailer Double Glazing Showroom Draper / Haberdasher Draughtsman Dry Cleaning Agent Electrical White Goods Retailer Estate Agent / Letting Agent Fireplace / Fireplace Surround Retailer Fish and Chip Restaurant/Take Away Fishing Tackle Retailer Fishmonger (Wet) Floor Covering Retailer Florist Furniture Retailer Garden Consumables Retailer Garden Equipment Retailer Gifts / Fancy Goods Retailer Graphic Designer Greengrocer Grocer (Licenced) Grocer (Unlicenced) Guest House Hairdresser Health Food Retailer Home Brew Materials Hosiery / Sock Retailer Hotel Household Goods Retailer Ice Cream Parlour Independent Financial Adviser Insolvency Practioner Insurance Intermediary / Broker Internet Cafe Investment Consultant Ironmonger / Hardware Retailer Kitchen Showroom Lamp / Lighting Retailer Launderette (Permanently Manned) Lawyer Lingerie / Underwear  Retailer Locksmith / Keycutting Marketing Consultant Mobile Phone Retailer Mortgage Consultant Motor Accessory Retailer Musical Instrument Retailer Nails Technician / Manicurist Newsagent Notaries Off Licence Office and Computer Consumables Retailer Optician Paint and Wallpaper Retailer Perfume / Cosmetics Retailer Pet and Animal Consumables Retailer Pet Grooming Parlour Photocopy / Fax Bureau Photographic Equipment / Studio Picture Framing Pound Shop Property Owner (Hair and Beauty) Property Owner (Offices) Property Owner (Retail - No Cooking) Property Owner (Surgery) Public House up to 6 Bedrooms Public House more than 6 Bedrooms Public House/Wine Bar (Excluding Cooking) Public House/Wine Bar (Including Cooking) Public Relations Consultant Radio TV Audio Equipment Retailer Record Audio and  Video Tape Retailer Restaurant/Bistro (Inc D.F.F. but NOT Range) Restaurant/Bistro (Inc Range) Sewing Machine Retailer Shoes / Boots / Bags  Retailer (Fashion) Shoes / Boots / Bags (Designer) Snack / Sandwich Bar (excluding DFF) Soft Furnishings and Home Accessories Retailer Solicitor / Barrister Sports Goods Retailer (Excluding Clothing) Sports Goods Retailer (Including Clothing) Stationers / Greeting Card Retailer Stock / Commodity Brokers Supermarket (Licenced) Supermarket (Unlicenced) Tailor / Dress maker (including sales) Takeaway (Excluding Deep Fat Frying) Takeaway (Incl Deep Fat Frying - Not Range) Takeaway - Deep Fat Frying by range Tanning Salon Telesales Toy / Game / Model Retailer Travel / Ticket / Booking Agents Video Library Wool Knitting and Needlework Products Retailer

POSTCODE *

ADDRESS 

GENERAL

PRESENT INSURER AIG Allianz Cornhill Insurance Plc AXA Insurance Company Limited CNA International Insurance Company, Birmingham Ecclesiastical Insurance Office Plc Folgate Insurance Company Limited Fortis Insurance GE Frankona Groupama Insurance Company Ltd Lloyds MMA New Venture NIG None Norwich Union Other Primary General Prudential Assurance Company Plc Royal & Sun Alliance St Paul's International Insurance Company Limited Unlisted Zurich Insurance Company

If New Venture, please state experience

If quotation Required is for Hotel/Guest House/Inn

How many letting rooms ?

Does Pub Trade exceed 40% of Turnover ? Yes  No 

Is any outside catering done ? Yes  No 

Does Entertainment take place ? Yes  No 

Any Childrens Play Facilities ? Yes  No 

Do you or a Manager Live on Premises ? Yes  No 

Do the Premises have any Felt on Timber Roofs ? Yes  No 

If Yes : Age 0 - 5 Years 6 - 10 Years 11 - 15 Years 16 - 20 Years >20 Years

Percentage 0 - 10% 11 - 20% 21 - 30% 31 - 40% 41 - 50% 51 - 60% 61 - 70% 71 - 80% 81 - 90% 91 - 100%

Does the Proposer Live on the Premises ? Yes  No 

Does the Proposer require Home Contents cover ? Yes  No 

Do the Premises have a Bells only Alarm ? Yes  No 

Do the Premises have a Digicom Alarm ?  Yes  No 

Do the Premises have CCTV ?  Yes  No 

Do the Premises have a RedCare Alarm ?  Yes  No 

Do the Premises have a RedCare GSM/ DualCom Alarm ?  Yes  No 

Does the Proposer Require Accidental Damage ?  Yes  No 

Does the Proposer Require Subsidence ?  Yes  No 

Do the Premises have an ATM machine ?  Yes  No 

When did the Proposer begin trading at this Premises ?  dd/mm/yyyy

CLAIM DETAILS

Number of Losses / Claims in the last 5 years 0 1 2 3 4 5 >5

Please provide details of all claims : Dates, Type of Claim and Loss Amount

SUMS INSURED

Buildings

Age of Building

Fixtures & Fittings

General Stock

Cigarettes & Tobacco

Alcoholic Spirits

Frozen Food / Deterioration of Stock

Electronic Business Equipment

Business Interruption 12 Months 18 Months 24 Months 36 Months

Fixed Glass/Signs/Sanitary Ware

Goods in Transit

Money in Transit/During Business Hours

Money in Approved Safe

Public & Products Liability

Employer's Liability

Additional Information

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