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Shopkeeper's Quotation
Proposer's Full Name and/or Trading Name  
Date Business Established:  
Risk Address Line 1    
Town  
City  
Postcode  
Trade  

Are the premises self-contained with their own lockable entrance door?

    Yes No
Do the premises contain a workshop?    Yes  No
Is the property of standard construction?    Yes  No
Floor type  
Buildings Sum Insured £
Tenants Improvements £  
Computers & Electronic Office Equipment £  
Cigars, Cigarettes & Tobacco £  
Wines & Spirits £  
Videos/Tapes/DVD's and CD's £  
Freezer Contents £  
Precious Metals/Alloys £  
Tools - Power & Non Power Driven £  
All Other Stock £  
All Other Trade Contents Excluding Stock £  
Does the premises contain an ATM?   Yes  No
MONEY    

Money on the premises during business hours, in transit or in a bank safe

 £
Money in a locked safe out of business hours £
SECURITY    

Are the premises occupied overnight by the proposer, any family members or employees?

   Yes  No

Are the premises situated in a modern enclosed shopping centre?

   Yes  No
Is there a fire alarm at the premises?   Yes  No
Are the premises subject to 24 hour security?   Yes  No
Is there a sprinkler installation at the premises?   Yes  No
Is there a CCTV system covering the premises?   Yes  No
Is there an intruder alarm at the premises?   Yes  No

Are grilles, bars or shutters fitted to shop front and all ground windows?

   Yes  No
BUSINESS INTERRUPTION    
What Gross Profit sum insured is required? £  
Indemnity Period  
STANDARD COVERS    
Goods In Transit sum insured £
Public Liability limit £
Number of employees    
Annual Turnover £  

Is there any work away from the premises other than collection and/or delivery?

   Yes  No
OPTIONAL COVERS    
Include Specified All Risks cover?   Yes  No
Include Theft by Employees?   Yes  No
Include Terrorism Cover?   Yes  No

 

CLAIMS  

Have/has you/your client sustained any loss or had any claim made against you/them, whether insured or otherwise, in respect of any of the covers required under this policy or any previously occupied premises during the last five years?

Yes  No
(If yes, please complete the details below)  

 

PROPERTY DATE OF CLAIM SECTION TYPE OF CLAIM CLAIM STATUS TOTAL COST
   
   
   
   
           

 
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General & Professional Insurance Brokers Ltd t/a Cox Braithwaite Insurance Brokers
Park House
Greyfriars Road
Cardiff, CF10 3AF

Telephone: 0800 975 3322
Fax: 029 2037 3687

   MOTOR INSURANCE
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PROPERTY OWNER'S INSURANCE		    

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