Quote Request for Buildings Only Insurance
To enable us to supply a quotation please complete the following:
Name Title E-mail In case we need to contact you for further information please tell us your daytime telephone number:
In case we need to contact you for further information please tell us your daytime telephone number:
Please check you enter your E-mail address correctly.
Date cover required from:
Address1:
Your postcode:
Your date of birth:
Occupation:
Employers business:
State occupancy details:
Enter the year your house was built:
Type of property:
Standard Construction? If no give details in the MATERIAL FACTS box at end of form:
How many bedrooms?
Is your house left unoccupied on a daily basis?
Buildings Value
What cover required for the building?
Do you have any of the following?
Yes No I have key operated window locks. Yes No I have 5 lever mortise locks on external doors. Yes No I have a NACOSS approved alarm. Yes No I belong to a neighbourhood watch scheme.
How many years claim free?
Any previous claims made should be disclosed, including dates, and amount paid.
Please indicate the current premium of your policy:
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