Tree Surgery Insurance, Arboricultural Insurance, Tree Surgeon Liability Insurance, Commercial Vehicle Insurance, Fleet Insurance

Self Employed Liability Insurance

The completion of this form in no way binds the Proposer to purchase insurance, nor does it bind Underwriters to give insurance.

Any information given will only be passed to Underwriters for the purpose of quotation and will be treated as confidential.

Commencement date of policy
Please enter the names of all Proprietors / Partners / Directors or Company name if applicable
Please enter trading name of business (Client Name if no business name available)
Address
Email Address
Postcode:
Telephone Number:
Please select the business status:
Please enter the Primary Trade or business:
If heat equipment is used in any of the above trades, please select the type used:
Does your work involve the use of asbestos, chemicals or other substances which could be harmful to health?	Yes No
Do you dispose of fumes, effluent or other harmful waste	Yes No
Please select the description of where the majority of the trade of business work is done
Has the proposer, director or partner ever has a proposal refused or declined, or had an insurance cancelled, renewal refused or had special terms imposed?	Yes No
Does the proposer, partners or directors of the proposer have any convictions for any criminal offence involving dishonesty arson theft or wilful damage or any prosecutions pending?	Yes No
For any of the classes of insurance proposed, has the proprietor any partner or director suffered any loss or had any claim made against them whether insured or not in the last 5 years?	Yes No
Has any of the proprietors, partners or directors been declared bankrupt or insolvent or been the subject of bankruptcy proceedings?	Yes No
Please enter the number of working proprietors and partners
Is cover for Employers Liability required?	Yes No
Excluding Partners & Proprietors, please enter the number of working directors & employees at anyone time engages solely in clerical work.
Excluding Partners & Proprietors, please enter the number of working directors & employees at anyone time engages solely in manual work.
Is cover required for loss of or damage to portable tools and business equipment and property transit?	Yes No
Do employees or labour only sub contractors use fixed woodworking machinery?	Yes No
Please select the required Public Liability Limit of Indemnity
Please check the details entered within this form carefully as they will form the basis of your insurance cover. Failure to disclose material facts or disclosure of false information could invalidate your insurance or result in the policy not operating properly or a claim not being paid. By submitting this form you agree to this condition.

Self Employed Liability Insurance, Shops And Offices Insurance, Commercial Insurance, Marine Insurance - Trust Insurance

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