Your Information

    Business name
    Business Address
    Description of business activities
    Number of years in business
    Contact Name
    Phone Number
    Email Address

    Construction of premises

    Walls
    Floor
    Roof
    Age of building

    Security At Premises

    Deadlocks on external doors?



    Key locks on windows?



    Alarm System?




    Other Security Include fencing, security cameras, bars etc.

    Fire protection at premises

    Fire Extinguishers?



    Hose Reel?



    Fire Hydrant?



    Sprinklers?



    Fire Alarm?



    Smoke Detectors?



    Fire protection at premises

    Fire Extinguishers?



    Hose Reel?



    Fire Hydrant?

    Property Damage

    Hose Reel?

    Please enter the sum insured for each of the following:

    Buildings:
    Contents:
    Stock:

    Business Interruption

    Annual Revenue:
    Indemnity Period:
    Additional increased cost of working: