Business Liability Insurance
TitleLiability Insurance Quote
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To help us provide you with out best possible quotation, please complete as much of the following liability insurance quotation form as you can.

* Indicates a required field
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Title
* Name
* Trading Name
* Address
*Postcode
*Telephone
*Email
Occupation/Trade
Number of Years Trading
Claims/Losses in the last five years
Public Liability
Employers Liability
 
In order to calculate the premiums for the Liability sections we will require the following information
Number of principals / partners (manual work)
Number of principals / partners (non-manual work)
Number of directors (manual work)
Number of directors (non manual work)
Number of employees (manual work)
Number of employees (non manual work)
Number of Labour only Sub-contractors
Number of principals / employees working away from premises
Projected Annual Turnover
Projected Annual Wages (manual)
Projected Annual Wages (clerical)
Maximum External Height Worked
Meters
Maximum Internal Height Worked
Meters
Any heat application:-
None - Blowlamps - Welding - Gas Cutting
Ever been declared bankrupt or insolvent?
Been convicted of any criminal offence, which is not 'Spent'?
Had any County Court Judgements entered in the last six years?
 
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arrow84 Church Street
Littleborough
Lancashire
OL15 8AU

Tel: 01706 378990
Fax: 01706 371417

Registered in England Number 939318

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the Financial Services Authority
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