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Public Liability Quote Request Form

Please complete the form below. We will pass your request to one of our panel of independent insurance brokers who will provide you with a discounted quote within 24 hours.

Your contact details

Name
Title
Company Name
Date Established
Business address   

 

E-mail address 
Phone Number
Best Contact Time

About your company

Manual employees

1 2 3 4 5 6 7 8 9 10

Clerical employees

1 2 3 4 5 6 7 8 9 10
Annual turn over
Trade/Occupation

Please include directors in the appropriate employee category. Partners or sole traders should only be included if they undertake manual work and should be entered in the manual employee category. If your trade or occupation is not shown above please provide a full description of your trade or occupation in the comments section at the end of this form.

About the insurance you need

Public liability

Employers liabilityYes No 
Tools of tradeYes No

Declaration

I/we have not had more than 2 claims or losses in the last three years exceeding £1000 in aggregate.
I/we will not undertake work outside of Great Britain, Channel Islands and Isle of Man.
I/we will not undertake work in or on aircraft operational areas, nuclear installations, petro chemical works & power stations.
I/we have never had a proposal or renewal declined, withdrawn or subject to increased terms.
I/we do not make payments to temporary employees and sub contractors in excess of 25% of annual turnover. 
I/we agreeYes No
Comments

  

Remember our service charter guarantees you

bulletLowest public, employer & product liability insurance quotes from leading UK insurance company's & Lloyds of London
bulletIndependent advice available on all types of liability insurance from our panel of brokers including high risk & difficult to place risks
bulletGuaranteed 5% online discount
bulletFlexible payment facilities, including cheque, credit card and monthly payment plans

Once you have received your quote you can arrange to start your new insurance cover over the telephone.

Remember our public liability insurance service charter is only available from our panel of independent insurance brokers.

 

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