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Name

Company name

Telephone

Postcode of premises (UK only)

Office

Postcode of Premises

Value of Computer Equipment

Value of all other General Contents

Gross Revenue

Number of Employees

Commercial Combined

Postcode of Premises

Value of Computer Equipment

Value of all other General Contents

Value of Stock, owned or held in Trust

Gross Revenue

Number of Employees

Professional Indemnity

Postcode of Premises

Type of Trade

Fee Income for last 12 months

Is Cover for Valuation Work Required

Level Of Cover Required

Any Previous Claims

Shop/Restaurant

Postcode of Premises

Value of Computer Equipment

Value of Stock

Value of all other General Contents

Gross Revenue

Number of Employees

Pub/Nightclub

Postcode of Premises

Dance Floor Area (Yes/No)

Value of Computer Equipment

Value of Stock

Value of all other General Contents

Gross Annual Revenue

Number of Employees

Classic Car

Postcode of Premises

Value of Vehicle

Age of Policyholder

Have access to at least one other Car?

Confirm claims in last 3 years?

Confirm no more than two convictions

Liability (Individual Tradesman)

Postcode of Premises

Occupation (Sic Code)

Payments to Bona Fide Sub Contractors

Gross Revenue

Liability (Companies)

Postcode of Premises

Occupation (Sic Code)

Number of Employees

Payments to Bona Fide Sub Contractors

Gross Revenue

Property Owner (Residential Buildings)

Postcode of Premises

Rebuild Cost Estimate

Is the property Occupied (Yes/No)

Property Owner (Commercial Buildings)

Postcode of Premises

Rebuild Cost Estimate

Is the property Occupied (Yes/No)

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