Title Page
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Insured name (name of entity that appears on your insurance policy)
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Contact person
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Email address
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Phone number
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Who is your insurance brokerage? (Business name)
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Name of broker of point of contact
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Broker Phone Number
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Broker email
General Details
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Address to be insured
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What is your main business activity
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What are you looking to insure?
- Property
- Crime/Theft
- Stock and Contents
- Liability
- Business Income
- Management Liability
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Does your building contain and asbestos?
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Are you able to estimate the overall percentage of the building covered by asbestos?
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Does your building contain and insulated panelling such as cool rooms or freezers?
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Are you able to estimate the percentage of floor space occupied by insulated panelling?
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Anything else you would like to tell us about your business?
