westcraveninsurance.com
Please complete the details below as fully as possible.
Title:
First names:
Last name:
Email address:
Business address (Please include trading name if applicable):
Business postcode:
Home address:
Postcode:
What cover is required? BuildingsContentsFull Package (business interruption, glass cover, money cover etc.)
Buildings:
Contents:
Wines & spirits:
Tobacco:
Stock:
BFixtures & fittings:
Is the building alarmed? Yes No
If yes, please give details:
Number of staff:
Approximate wage bill:
Estimated annual turnover:
Do you have a claims history (within 5 years)?: Yes No
Date: D: M: Y:
Details of loss:
Amount: