Commercial Express: Shop Liability
Eunisure Adviser Name
*
Client Name
*
Business Proprietor/Director Name
*
Please enter the full business name and any trading names as they would appear on your policy document
*
Address for correspondence
*
Date of Birth
*
/
Month
/
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Best contact time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Address for business trading if different
Please answer the following questions in respect of the premises the insured trades from
What year did the insured start trading at these premises?
(This will calculate a no claims bonus)
Has the insured been trading at another location in this line of business no more than 30 days ago?
Yes
No
The premises of the business being proposed:
a) were built after 1700?
Yes
No
b) are occupied throughout the year?
Yes
No
c) are in a good state of repair?
Yes
No
d) are built of brick, stone or concrete and roof made with slate, tiles, metal, concrete or flat roofed with felt on timber, asphalt, bitumen or concrete?
Yes
No
e) has a flat roof?
Yes
No
f) has a listed building status?
Yes
No
Has the property ever suffered from:
a) flooding or is in an area troubled by flooding?
Yes
No
b) subsidence, landslip or heave?
Yes
No
Please answer the following questions in respect of the property use
Is the whole property to be insured under this policy?
Yes
No
Is the insured the sole occupant of the property?
Yes
No
If there is any residential section to the property, does it account for 70% or more of the total premises area?
Yes
No
Does the insured or a manager reside at the property?
Yes
No
Trade
Is the sale of goods in large quantities for resale to the consumer?
Yes
No
Trade
Brief description of Trade
Interested parties
Doe the insured need to note an interested party on the policy
Yes
No
Please provide details about the security at the premises to be insured
Doors:
Are all exit doors fitted with a mortice deadlock conforming to BS3621 with boxed steel striking plate of a minimum of 6 inches in length?
Yes
No
If present, are all aluminium doors fitted with a cylinder mortice deadlock?
Yes
No
If present, are all fire exits fitted with a panic bar, redlam bolt, and hinge bolts top and bottom?
Yes
No
Windows
Opening basement and ground floor windows and fanlights and on other opening windows fanlights and skylights which are accessible from roofs balconies and canopies fire escapes or downpipes (but excluding windows fanlights and skylights fitted with bars or grilles ) are all fittrd with either:
a) key operated window locks with the keys removed when in operation or
Yes
No
b) solid steel bars (not less than 3/4" diameter and more than 5" apart securely fixed to the brickwork or masonry surrounding the window
Yes
No
Are all shop front windows and doors protected by a metal roller, shutter or grill ?
Yes
No
Alarms
Is there an annually maintained intruder alarm fitted and operational that gives complete protection throughout the insured premises?
Yes
No
Buildings
Buildings, including landlords fixtures & fittings and tenants improvements £
£
Do you require Accidental Damage Cover?
Yes
No
Do you require subsidence, landslip, or heave?
Yes
No
Loss of rent
Loss of Rent (receivable) £
£
Indemnity Period
12 Months
24 Months
Choose 12 or 24 months
Contents and stock
Contents, including trade fixtures and fittings, machinery and plant £
£
General Stock £
£
Do you require Accidental Damage cover on contents and stock (also for All Risks, if applicable)
Yes
No
Standard cover with policy can be increased if wish
Extra Covers:
Frozen Food £
£
Loss of License £
£
Book Debts £
£
Do you require Accidental Damage cover for Book Debts?
Yes
No
The policy provides standard package benefits based on the sum insured for the standard covers. These may be increased if required.
Standard Package Benefits:
Business Interruption - Calculated £
£
Indemnity Period
12 Months
24 Months
Goods Transit (owned or operated by the insured) £
Glass, canopies and signs £
. Optional please state Yes/No
Yes
No
Terrorism - Is cover required for terrorism? (not available in Northern Ireland)
Loss of Money (standard Cover in shop Policy Can be increased)
Money in Automated Telling Machine (ATM) £
£
In the premises during business hours or in transit or bank night safe £
£
In a locked safe or strongroom £
£
In the premises outside business hours £
£
In the private dwelling or domestic living quarters of the insured, director, partner or authorised employee £
£
In gaming amusement or vending machines £
£
Personal assault extension (standard in policy can be increased)
a) Death or permanent total disablement £
£
b) Temporary total disablement (per week) £
£
Policy level liability covers
Employers' liability £10,000 Standard
Public and Products liability ?
£ 2 Million
£ 5 Million
£2 mil or £5 mil
Is there any work undertaken away from the premises other than collection or delivery?
Yes
No
Employer Reference Number ERN / Employer PAYE ref
Only a very tiny minority of employers that do not pay salaries through PAYE are exempt from providing an ERN. All employers who pay PAYE must provide an ERN.
Please provide ERN number
Is the company exempt from having an ERN?
Yes
NO
Has the insured:
Ever had insurance cover refused or cancelled or special terms imposed?
Yes
No
Ever had any claims or incidents at these or any other premises in the last 5 years?
Yes
No
Ever been declared bankrupt or been the subject of any winding up petition or order in this or any previous business?
Yes
No
Ever been prosecuted under the Health & Safety at Work act?
Yes
No
Have any County Court Judgements or any arrangements with creditors outstanding?
Additional Information
Any further information or material facts you should or would like to advise the Underwriters
Submit
Should be Empty: