Helpline: 01555 555555

Quotation Request

Residential Landlords

Statement of Facts
Property Details
Claims Details
Optional Extras
Client

Statement of Facts

You or any of your partners or directors either personally or in connection with any business which you/they have been involved have never :-

been declared bankrupt or are the subject of any current bankruptcy proceeding or any voluntary or mandatory insolvency or winding up procedures?
- been disqualified from being a company director?
had a County Court Judgement or Sheriff Court Decree?
been convicted of or charged with ( but not yet tried ) a criminal offence other that a motoring offence or a spent conviction in accordance with the "Rehabilitation of Offenders Act 1974"?
been prosecuted or have prosecutions pending under the Health and Safety at Work Act or any other statute or regulation?

Property Details

When would you like cover to start ?
Address (line 1)
Address (line 2)
Town
County
Post Code
What year was the Property built?
Is the Property listed?
Is the Property in an area that is free from flooding ?
Is the Property in a good state or repair?
Is the Property free from and in an area which is free from any signs of subsidence, heave or landslide ?
Is the property constructed of brick, stone or concrete and roofed with slate, tiles, metal or concrete or built and or roofed of sheets composed entirely on incombustible material ?
If 'No' please provide details
Are all final exit doors fitted with 5 lever mortice deadlocks and ground floor and other accessible windows fitted with key operated locks?

Sums Insured

Buildings Sum Insured
£
Is Accidental Damage Cover Required for Buildings? (not available for Unoccupied)
Is Subsidence, Heave and Landslide Cover Required for Buildings?
Annual Loss of Rent (20% included as standard)
Contents Sum Insured
£
Is Accidental Damage Cover Required for Contents? (not available for DSS where contact is not between landord and tenant or Unoccupied)
Would you like to add the interest of a third party?
Please provide details?

Claims Details

Within the last 5 years, have you or any of your partners or directors in connection with any business which you/they have been involved had any losses whether insured or not or had any claims made against you?
Date of Claim
Please provide details of the claim?
Do you know the claim costs for this claim
Total Cost or Amount Outstanding
£
Are there any more claims?
Please provide full details

Optional Extras

Cover available for Tenant Disputes, Eviction of Squatters, Defence Prosecutions & Legal & Tax Advise
Do you require legal expenses?
Indemnity Limit
£
Would you like to extend cover to include Rent Indenity? (only available to Professional Lets)
Please provide your rental income for 12 months on Property 1?
This cover is only available to Professional Tenants
£

Client

CA1
CBD
CCN
ClientContact
CMobile
CPhone