QUOTATIONS

Simply complete the form below and we will send you your quotation by return. All quotations provided, whether written or verbal, are subject to confirmation through the completion of a proposal form (which will be sent to you). Terms, premiums and conditions may change if the information given in the proposal form is different from that disclosed by you at quotation stage.

LISTED/PERIOD PROPERTY QUOTATION REQUEST Title   First name   Surname     Address of property to be insured   Postcode     Date of birth   Occupation     Correspondence address (if different from above)     Telephone   Email       Is the property your main address?     Yes    No   If "No", is it: Second home (no letting) Let to tenants Let holiday home Unoccupied     Is the property close to any rivers, streams or tidal waters?     Yes    No   If "Yes", please give details:     Has the property suffered from, or has it been monitored for, landslip, subsidence or heave?      Yes    No   If "Yes", please give details:     How old is the building?   If it is listed, is it:   Grade One   Grade Two   Two-Star     Construction of the property: Walls: Roof:     What precautions are in place? (Tick all that apply) Smoke detectors   Fire blanket Fire extinguishers Spark arrestor     Are all external doors secured by 5-lever mortice deadlocks or cylinder locks complying to BS 3621? Yes    No   Are all opening, accessible windows fitted with key-operated locks? Yes    No   If you have answered “No” to either of the above two questions please provide details of the security:     Please provide details of any alarm system:   Bell/siren only   Redcare Central station   Digital communicator             Is the alarm maintained annually by a NACOSS approved company? Yes    No     Please provide brief details of any other security arrangements (e.g. safe, Neighbourhood Watch etc.):     Please specify sums insured required: Buildings   £   Cover: Accidental Damage General contents   £   Cover: Accidental Damage Antiques*   £   Cover: Accidental Damage Pictures*   £   Cover: Accidental Damage Silver & plate   £   Cover: Accidental Damage Jewellery   £   Cover: All Risks, Worldwide Personal effects (cameras, watches etc)   £   Cover: All Risks, Worldwide Pedal cycles   £   Cover: Accidental Damage   *Can be included under “ General Contents” but attract a lower rate if separately listed.   Excess preferred (there is a compulsory £1,000 landslip, subsidence and heave excess and £50 all other claims):   BUILDINGS   CONTENTS     £100   £100     £150   £150     £250   £250     £500   £500     £1000   £1000       Have you or any other person living with you sustained any loss or damage during the past five years (which would have been covered by this type of insurance had it been in force) whether or not a claim was made? Yes   No   If "Yes", please provide date, details and amount of each loss or damage incident below: Date   Details   Amount     £               £               £               £               £     How would you like us to contact you with your quotation?   Telephone Email   Post Fax         Fax number:     How did you hear about us?     Additional comments: