Please state your annual turnover
(gross income)

Do you have any employees?

If yes please state your annual wageroll

Do you have any unpaid voluntary helpers?

Have there been any claims/complaints against you or the business in the last 3 years?

Public Liability Limit of Indemnity required

Do you require cover as a microchipper?

Do you require personal accident cover?

Buildings (rebuilding cost)

Fixed glass and lettering (shop windows)

Tenants improvements

Fixtures and fittings

Trade contents

General stock

Business interruption

Theft of money £1,000

Small hand tools

Machinery and fixed equipment

Other

If Other, please describe