Business Liability Insurance - Quotation Form

To speak to an advisor phone 01332 299285

To obtain your quotation please submit the on-line form below * = required field

1. Company Information

Contact Name: * Company Name: Nature of Business: Address 1: Address 2: Address 3: Town: County: Postcode: Telephone: * Date established E-mail: *

2. Total turnover for the last complete financial year

£

3. Estimated Annual Turnover

£

4. Number of partners, directors doing manual work

5.Number of partners, directors doing purely non manual work

5. Number of employees doing manual work

6. Number of employees doing non manual work

6. Public Liability Limit required (we will automatically quote for £10m limit for employer's liability)

£1 Million £2 Million £5 Million

7. Any claims in the last 5 years?

Yes No If so please give details:

Our quotation will assume the following:

1. Annual payments to temporary employees will not exceed 25% of annual wage roll   2. Annual payments to labour only subcontractors will not exceed 25% of annual wage roll

If you experience problems with the on-line quotation form please contact us

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