Please only complete & submit the following details if you are applying for a quotation in your individual name.

If you require a quotation for a Limited Liability Company, please contact us on 01252 735806

For First Aid and/or Health and Safety please see the separate First Aid form under the Quote Request Menu





YesNo
If yes please go straight to address details.
If no, what is your Company name and your company’s legal status?

Other:
This is the name that will be shown in your policy

Please Answer the following for each activity requiring cover

Activity One
YesNo
If no please pass on to Q4

Please move next to Q5

And when is it scheduled to complete?
YesNo
If so, by who?
Click Here For Activity Two
YesNo
If no please pass on to Q4

Please move next to Q5

And when is it scheduled to complete?
YesNo
If so, by who?
Click Here For Activity Three
YesNo
If no please pass on to Q4

Please move next to Q5

And when is it scheduled to complete?
YesNo
If so, by who?
I confirm I have read and understood the Terms of Business Agreement