Commercial Express: Unoccupied Commercial Property

Commercial Express: Unoccupied Commercial Property
Proposal / statement of fact
Adviser Name*
Insured
It is essential that you make fair presentation of the risk that should include a full and unrestricted disclosure including every material fact and circumstance (a material fact or circumstance is material if it would influence the judgement of the Underwriter when considering whether to accept the risk and /or the assessment of the terms, conditions or premium which should be applied).

If you are unsure in any way that your disclosure is complete you should check with your insurance advisor.

In the event you fail to make a full unrestricted disclosure Underwriters may refuse to pay your claim, pay only part of your claim, and /or void your policy.

This statement will be considered together with the presentation of risk that you and your insurance advisor have provided to the Underwriter.

If the answers or information you have provided change during the period of insurance you should notify your insurance advisor as soon as reasonably possible as Underwriters may be unable to continue with cover.
Please enter the full business name and any trading names as they should appear on your policy documents.*
Business Proprietor/Director Name*
Your correspondence address:*

Street Address

Street Address Line 2

CityCounty

Post Code
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Telephone number of the insured*
Best Contact Time*

:HourMinutesAM/PM Option
Property information
What year did the insured first own these premises?
Is the whole building to be insured under this policy?

YesNo
a)The building to be insured was built
Approx Year
b) Is in a good state of repair?

YesNo
c) has composite panelling?

YesNo
d) is built of brick, stone, metal or concrete and roof made with slate, tiles , metal, concrete or flat roofed with asphalt, bitumen or concrete?

YesNo
e) has a flat roof?

YesNo
f) has a listed building status?

YesNo
g) has been inspected by the Fire Authority?

YesNo
Have all the Fire Authority Requirements been met?

YesNo
Has the property ever suffered from:
a) Flooding in an area troubled by flooding?Please note that flood cover is only available if the property is fully occupied or wider perils have been selected.

YesNo
b) subsidence, landslip or heave or in an area troubled by subsidence, landslip or heave?

YesNo
Is the property to be demolished?

YesNo
Has planning permission been refused at the premises?

YesNo
Definition of standars renovation

Internal painting and decorating, tiling, replacement of bathroom and/ or kitchen fixtures and fittings including sinks, wash basin, W.C, bathroom and shower, carpeting, internal joinery, plastering, central heating installation and external window replacement.
Is there any structural work to take place outside the definition of standard renovation (above)

YesNo
Use of insured property

Details of the property's configuration and occupants:
If there is any residential section to the property, does it account for 70% or more of the total premises area?

YesNo
Trade of tenant: If any commercial section is unoccupied state "unoccupied"
Please note that if a Restaurant where more than 15% of turnover is from the takeaway aspect, then this should be rated as a Takeaway
Level of cover required whilst unoccupied?
Wider perils defined as fire, lightming, explosion, aircraft or other aerial devices or articles dropped therefrom, subsidence, landslip, heave, riot, civil commotion, strikers, locked out workers, persons taking part in labour disturbances, malicious persons, earthquake, storm, flood or impact by any road vehicle or animal, falling trees, branches and falling aerials unless otherwise stated in the conditions of this certificate.
Is the property Commercial or Industrial?
Has the property previously been used as a place of worship, school, college, public house, or any licenced premises?

YesNo
Has the property been unoccupied for more than 3 years?

YesNo
Are you unsure as to the suitability of the risk or is there more than one trade in the property?

YesNo
Does the trade exactly match the trade your property is used for?

YesNo
Third party interest
Does the insured need to note the interest of an interested party?

YesNo
Cover required
Building Sum Insured (including Landlord's fixtures and fittings)
£
Is Accidental Damage Cover for Buildings required? (not available if unoccupied or certain trades)

YesNo
Landlord's Contents Sum Insured (not available for business contents)
£
Book Debts- Customer's Debit Balance (not available if unoccupied)
£
Property Owners Liability: Shop front glass sum insured (not available if unoccupied)
£
Loss of Rent Sum Insured (not available if unoccupied): Loss of Rent is automatically included at 20% of the Building's sum insured. If more than 20% is required please enter the excess amount
£
Is cover required for terrorism?

YesNo
Excesses (unless excluded or amended in the special conditions)
All perils other than property owners liability, subsidence, landslip and heave
£
Subsidence, landslip and heave
£
Shop Front Glass (not applicable if property unoccupied)
£
Book Debts (not applicable if property unoccupied)
£
Loss of Rent (not applicable if property unoccupied)
£
Property Owner's Liability
£
Disclosure and claims

Has the insured:
a) ever had insurance cover refused or cancelled or special terms imposed?

YesNo
b) or insured family member ever been convicted or cautioned with any criminal offence, other than driving offences?

YesNo
c) ever had any claims or incidents at these or any other premises in the last 5 years?

YesNo
d) ever been prosecuted under the Health and Safety at Work Act?

YesNo
e) ever been declared bankrupt or been a director of any company that went into liquidation?

YesNo
f) any County Court Judgements or arrangements with creditors outstanding?

YesNo
Additional Information: Any further information or material facts you should or would like to advise the Underwriters?
I can confirm I have read and understood all questions relating to this quotation

Yes
Should be Empty:

Commercial Express: Unoccupied Commercial Property

Proposal / statement of fact

Insured

Property information

Use of insured property

Third party interest

Cover required

Excesses (unless excluded or amended in the special conditions)

Disclosure and claims