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Insurance Quote Request

www.4residents.co.uk


Fields marked * MUST be completed.

YOUR DETAILS  
Title: Name: *
 Mr:  Mrs:  Ms:
Postal Address: Town:
County: Postcode:
Phone: Mobile:
Fax: Email:
POLICY HOLDER DETAILS  
Name of policy holder(s): Address of building to be insured:
Town: County:
Postcode:  
Type of property:
No. of units   No. of floors
 
Approximate date built/converted: Month: Year:
e.g. 08 / 1965
YES NO
   
Is the property occupied?
   
Standard construction i.e. brick with tile/slate roof?
   
Is more than 10% of the roof flat?
   
Is the property in a good state of repair?
   
Is there any evidence of subsidence, ground heave or landslip?
   
Is the property a listed building?
   
Is there a managing agent?
If yes, which one?
Statement that best describes residents:
   
YES NO
   
   
Have you been refused insurance or had special terms/ conditions imposed?
   
Are there any communal facilities ( lift, boiler, swimming pool, gym, etc)?
   
Are there any commercial units ( e.g. shops or offices)?
If yes please state details?
   
YES NO
   
Have there been any claims made during the last 3 years?
 
If yes how many?  Please provide details in the comments box
Total value of claims paid? (Confirmation will be required)
Any comments etc...
Policy renewal date:   /    /  
Sum insured: (i.e. declared value) Current premium:
   
Current insurer: Current excess:
   
YES NO
   
   
Is Employers Liability required?
   
Is Terrorism cover required?
   
Is engineering cover required ( lifts/boilers)?
   
Is Directors and Officers cover required?
You must provide all material information likely to influence the acceptance of this insurance. If you are in any doubt as to whether a fact is material it should be disclosed. Failure to disclose all material facts may invalidate your policy.


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Further Information
Royal Institution of Chartered Surveyors (RICS)

Association of Residential Managing Agents (ARMA)

Surveyors and Valuers Accreditation (SAVA)