|
 |
Public Liability Insurance
|
 |
| |
|
GJT
Hodgson Insurance Services specialise in public and employers
liability insurance for self employed tradesmen. We cater for
all types of small businesses with up to 6 manual workers including builders, carpenters,
carpet cleaners, gardeners, plumbers, heating
engineers and all other types of trade in the building and domestic industry,
including limited companies.
Cover can include trade tools, goods in transit and contract works cover.
With over 30 years experience in the insurance trade, we
search a panel of insurance companies to find you the best price with the
right cover.
For a cheap public liability insurance
quotation simply complete the quotation form below, and submit it
to us. We will
contact you as soon as possible with a quotation. Alternatively
contact our office on 01288 353999, where we will be more than pleased to
arrange a quotation. |
| |
Public Liability
Insurance Quotation Form
|
|
Company Details |
| Company/Trading
name: |
|
| Full names of
principals, partners and directors: |
|
| Business address: |
|
| Business postcode: |
|
| Your trade or
business (Please give a full description): |
|
| Date this business
was established: |
|
| How many years
experience in the trade: |
|
| Do you operate
from commercial premises or home address: |
|
| |
|
|
How many people
are involved in manual work?... |
| a) Principals,
partners, and directors
: |
|
| b) Employees including labour only sub-contractors, and people working under Government Schemes
(maximum number required at any one time is required) : |
|
| How many people
are involved in clerical only work? |
|
| |
|
|
The Cover You
Require |
| Public liability
cover (compulsory indemnity limit required): |
|
| Is employer's
liability cover required?: |
Yes
No
|
| |
|
| Do you required
the following extensions of cover to apply?... |
|
| Injury to working
partners (if another partner is legally liable) |
Yes
No
|
| Employers'
liability cover for employees using fixed woodworking machinery: |
Yes
No
|
|
if YES: How many
persons use such machinery: |
|
| Is Tools cover
required (includes hand tools and hand held portable tools used in
connection with business)?: |
Yes
No
|
|
if YES: What sum
insured is required: |
|
| Is Goods in
Transit cover required (only available if tools cover if selected): |
Yes
No
|
| |
|
|
Your Business
Activities, Previous Insurance And Claims History |
| Do your payments
to bona-fide or supply and fix sub contractors exceed £ 30,000 per annum?: |
Yes
No
|
| Do you undertake
work away from your premises involving the use of heat, welding or flame
cutting equipment?: |
Yes
No
|
| Do you hire out
plant and/or machinery to other persons or firms?: |
Yes
No
|
| Do you undertake
work involving the installation, service, maintenance, or repair of gas
appliances, pipe work, equipment or flues?: |
Yes
No
|
|
if YES: Are you
CORGI Registered or will such work be undertaken solely by CORGI
registered persons?: |
Yes
No
|
| Has any insurer
cancelled, declined to provide or renew cover or imposed special terms in
respect of the risks now proposed?: |
Yes
No
|
| Have you or any
partner or director been convicted in the last 5 years of any offence
relating to the Health & Safety of your employees or members of the public
in connection with your business?: |
Yes
No
|
| Have you or any
partner or director been convicted or is any prosecution pending for any
offence involving dishonesty of any kind including for example |
Yes
No
|
| Have you made any claims or suffered any
losses during the last 5 years whether covered by insurance or not?: |
Yes
No
|
|
if you have answered 'YES' to the above
questions, please put full details in the box opposite: |
|
|
If your trade or business is a
BUILDER or PROPERTY MAINTENANCE only, state whether: |
| your annual turnover for SEPARATE CONTRACTS
will exceed 15% for painting & decorating, roofing, groundwork's or
plumbing & heating?: |
Yes
No
|
| your annual turnover for SEPARATE CONTRACTS
will exceed 5% for timber treatment, damp proofing or civil engineering?: |
Yes
No
|
|
For the trade of BUILDERS and BRICKLAYERS
state whether: |
| you undertake any external work at a height
from the ground of more than 15 metres or any internal work from the floor
of more than 15 metres?: |
Yes
No
|
| you solely undertake work on private
dwellings, shops, offices, hotels, public houses, guest houses, schools,
colleges, residential, retirement or nursing homes, of not more than four
floors including basement and attic (including the grounds thereof)?: |
Yes
No
|
|
Your Contact Details and
Current Insurers |
|
Renewal/Inception date: |
|
|
Current insurers (If
applicable): |
|
|
Renewal/Target premium: |
|
|
Contact name: |
|
|
Email address:
|
|
|
Telephone number:
|
|
|
Preferred choice of quotation contact:
|
|
|
Preferred payment method:
|
|
| |
|
|
Please now
submit the public liability quotation form through to our office to arrange your
quote. |