Business Combined Proposal Form

PARTICULARS OF BUSINESS
Year of construction of the buildings
Are you the tenant or the owner of the building?
Are the buildings to be insured constructed of brick, stone or concrete and have roofs of not flammable material? External walls.Roof/ceiling?
If no,please give details to their construction
Please state the use/occupancy/business transacted on any neighbored,connected or communicating premises and,if multistored building, the use/occupancy/business transacted on each floor
In which floor is the property to be insured contained
In the case that the building to be insured has basement, please state the measure taken to avoid flooding
How many fire extinguishers are there on the premises?
Please state how the Outer doors and Outer windows (back/side/sky lights)are secure/protected?
Have you taken any measures in order to protect your property? (Fire/Burglary Alarms, Safe Boxes, Smoke detectors)
Have your business has ever been insured?
If yes, which insurance company
Is part of your business transacted in any other premises?
If yes, please state the company where these premises are insured.
How long are you in the business?
Please give details below, if, in respect to any risk to be insured, you have incurred any loss or damage or made a claim or had made against you DURING THE LAST THREE YEARS.
Date
DD slash MM slash YYYY
Details of Incident
Amount Paid
Outstanting
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Business Combined Proposal Form

Step 1 of 2

Personal Details

Period of insurance

Cover Required

FIRE AND BURGLARY

EXTENSIONS AVAILABLE

SPECIAL PERILS

CONSEQUENTIAL LOSS

EXTENSIONS AVAILABLE

PUBLIC LIABILITY

ESTIMATES

EXTENSIONS AVAILABLE

GLASS

EXTENSIONS AVAILABLE

PARTICULARS OF BUSINESS

Please give details below, if, in respect to any risk to be insured, you have incurred any loss or damage or made a claim or had made against you DURING THE LAST THREE YEARS.