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Contact name: |
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Management Company or Owners
name: |
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Your interest in the property.
I am: |
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Correspondence address only: |
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Correspondence postcode: |
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About The Property
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Full address of property to be insured: |
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Risk postcode: |
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Date flats
purchased or to be purchased: |
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Number of flats in block: |
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Number of storeys (Incl ground
floor): |
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Is the property purpose built
or a a conversion: |
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Year property was originally built: |
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If converted to flats, what year was the
conversion done: |
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Is the property a listed building: |
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Construction of property (walls)? |
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Construction of property (roof)? |
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What percentage of the total roof is flat? |
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Construction of stairs: |
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Construction of floors between properties: |
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How many passenger lifts do you have: |
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If Yes,
would you like a quote to have the lifts formally inspected as required
under the Health & Safety Regulations: |
Yes
No |
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Use Of
Flats |
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How many of the flats are
currently............. |
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...Owner occupied: |
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...Let to working professional/retirees under
Assured Shorthold Tenancies: |
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...Let directly to the local authority: |
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...Let to DSS referrals: |
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...Let to students: |
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...Non AST lets/under 6 months let: |
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...Holiday Let: |
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...Owners second home/holiday home, not let: |
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...Unoccupied: |
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The total in the boxes above should add up to
the total flats in the block. |
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Cover |
Buildings: This must represent the full
re-building costs of the block of flats, including debris removal and
architects fees. It is not based on the current 'for sale' value.
Communal Contents: This covers the companies contents within the property, i.e.
hallway carpets, blinds, furniture etc.
Loss Of Rent: This covers what you will lose out in rent in
the event your property becomes uninhabitable after an insured peril.
This cover will be set on each policy depending on buildings sum
insured.
Directors & Officers: This protects directors and officers
against litigation or claims arising from their actions and decisions
made on behalf of the company in respect of the flats.
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What cover do you require?: |
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Buildings cover required, What Sum Insured?:
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If Communal Contents cover is
required, What Sum Insured?: |
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Is a Directors & Officers policy required for
an additional premium?: |
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Other Information
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Has the proposer, management
company or directors made any claim, had any loss or had a claim made
against them in the last
5 years?: |
Yes
No |
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Is the property situated within 400 metres of a river, watercourse,
sea, cliff or quarry or in a flood risk area? |
Yes
No |
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Has the property suffered or any neighbouring
properties suffered with any damage caused by subsidence, heave or
landslip or had any underpinning or remedial action done to the
property? |
Yes
No |
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Has the business or any directors/officers ever been declared bankrupt, gone in
to liquidation, been disqualified from being a company director or had an insurance policy declined, refused, cancelled
or had special terms imposed or been convicted of any criminal offence (excluding
motoring convictions)? |
Yes
No |
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If you have answered
'Yes' to the above questions, please give full details here,
including dates, costs, circumstances and distances and heights etc:
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Material Facts. If you have any further
information or material facts you feel we should know and what could
possibly affect the policy please add it in the box here: |
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Inception/Renewal Date for
policy: |
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Current insurers (If
applicable): |
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Renewal/Target premium: |
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Preferred payment method for
insurance policy: |
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