• Public Liability Enquiry Form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION & QUOTATION REQUEST

Brochure/Quotation Request

Name e-mail

 

Telephone No.

Address:

 

Scheme details required:

 

Occupation: EL Limit of Indemnity:

Cover available for the following Occupations  Please select an occupation from the following list that best describes your business activities

 



Date business established
Risk postcode

Cover start date:


Public liability (mandatory)

Total number of Principals, Partners, Directors and Employees


How many are involved in manual duties?  



Limit of indemnity required Please select...


Other Covers (Optional)

Do you employ temporary employees?  

 


Is cover required for hired-in plant?

 


Is cover required for your own plant?



Is cover required for contract works?



Would you like to include Tools, Equipment and Contract Works cover?



Would you like to include Personal Accident cover?


   

 

Your quotation will be e-mailed

 

Thank You


 

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