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QUOTATION FORM - Back

 
Name:
Date:
 (22/12/2007) *
 
Address:
Post Code
 
Type of Business:
 
 
 
 
 
Construction:
  
 
 
Buildings:

Roof:
 
Floors:
Age:
 
Alarm:
Physical:
 
 
 
 
Claims History:
Type
Value
Year
 
 
 
 
 
 
 
Sums Insured:
 
 
 
Buildings:
Money in Transit/Premises :
 
F&F, M&P :
Money in Safe:
 
Computer Equipment :
Personal Accident/Assult :
 
All Risks to Business Machines :
Goods in Transit :
 
Cigarettes & Tobacco:
Loss of Licence:
 
Wines & Spirits :
Book Debts :
 
General Stock:
Wages: Clerical:
 
Frozen Food :
Wages: Manual:
 
Rent:
Labour Only:
 
Glass External/Internal:
Wages Away:
 
Business Interruption:
Turnover:
 
 
 
 
Cover Required:
  
 
 
Fire/Perils:
Subsidence:
 
Accidental Damage:
Employers Liability:
 
Theft:
Public Liability:
 
Products Liability:
 
 
 
 
 
Comments:





 
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Brady Insurance Services Ltd Registered office 13 Dublin Road, Enniskillen, Co..Fermanagh, BT74 6HQ T. 028 6632 4371 F. 028 6632 4557
Brady Insurance Services Ltd is authorised and regulated by the Financial Services Authority | Registered in N. Ireland Reg No: 24819
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