T^R direct
T & R Direct Insurance Services
shop & office insurance

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Shop & Office Insurance Form

If you would like to contact us to enquire about Commercial Insurance, please fill in the form below, and please note that all fields marked with * are mandatory.

T&R Direct Insurance

Contact Details:

Title:

First Name*:

Surname*:

Trading Name:

Email*:

Telephone:

Address 1:

Address 2:

Town:

County:

Postcode:

Cover date required: (dd/mm/yy)

   
Risk Details:

Trade Description:

Business Risk Address: (if different from above)

Company status:

Date trading from:

Experience in trade:

Have you ever been declared bankrupt?

Have you any criminal convictions?

Do you handle any hazardous substances?

Have you ever had insurance refused?

Have you made any claims in the past five years?

 

 
Cover Details:

High Risk Items / Fancy Goods:

Frozen Foods Value:

Refrigerated Units:

Buildings Cover:

Buildings Cover Type: (Standard or Accidental Damage)

Goods In Transit:

Personal Accident:

Legal Expenses Required:

Yes
No

Business interruption required? If so what Level?

Indemnity Period:

12 months
18 months

Loss of Rent Required? If so how much?

Book Debts Cover? If so how much?

Level of Public Liability:

1 million
2 million
5 million

Do you require Employers Liability?

Yes
No

 

 
Risk Address Details:

Wall Construction: (e.g. Standard or Non-Standard)

Roof Construction: (e.g. Standard or Non-Standard)

Floor Construction: (e.g. Concrete or Timber)

Burglar Alarm: (e.g. Nacoss Approved)

Alarm Type: (e.g. central station, bell, or digital)

Is there any CCTV?

Do you have sole occupancy?

Location: (e.g. Shopping Centre, High Street)

Do you have a basement or cellar?

Do you require subsidence cover?

*required

 

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© 2007 T&R Direct Insurance 6 Concept Park, Innovation Close, Poole, Dorset, BH12 4QT
Telephone: 0845 67 300 80 / Fax: 01202 739347
E-mail: enquiries@trdirect.co.uk

T&R Direct Insurance - best for Cheap Insurance UK, House Insurance and Car Insurance.