Contractors All Risks Quotation Form

Please insert your details here and one of our commercial advisers will contact you with a contractors all risks insurance quotation shortly.

This form is designed for contractors/developers requiring annual contractors all risks insurance whilst working at a contract site and with a regular flow of jobs throughout the year. Regrettably, we cannot provide quotations for 'one-off' or 'single contract' developments.

The policy can provide annual cover for public and employers' liability and/or contract works (materials, etc.), own plant, hired-in plant, employees tools and temporary buildings.

If you have any problems with completing this form, please phone us on 01623 641 386 for assistance.

General Contact Information
Proposer's Full Name(s): (enter sole trader's name or all partner's names if a partnership)
Contact Name: (if different to proposer's name)
Limited Company Name: (if operating as a limited company)
Do you require cover for any subsidiary companies?	Yes     No
If yes, please provide the name(s) of any subsidiary company(s) that you wish to include under your insurance:
Trading Name/Trading As: (if different to the above)
Trading Status:	- - - - - - Please Select - - - - - - Sole Proprietor Partnership Limited Company Limited Liability Partnership Unincorporated Association
Occupation/Trade: (e.g. builder, property developer, etc.)
Business Address:
Postcode:
Telephone Number:
*E-Mail Address:
*Please note that your email address will only be used to provide you with your quote and not for any other marketing purposes.
General Information
Type of Contractors All Risk policy required:	Annual (multi-contract) Policy     Single (one-off) Contract Policy
	Please note that regrettably we are unable to provide quotes for single one-off contracts.
Have you, or any other partner or director ever been convicted of or charged (but not yet tried) with any criminal offences other than a motoring offence?	Yes     No
If yes, please provide details of the conviction(s): (e.g. type and reason for conviction(s))
Date of Conviction/Offence:
Details of any fines and/or community service: (Please enter 'None' if you did not receive any fines and/or community service)
Length of custodial sentence(s): (Please enter 'None' if you did not receive a custodial sentence)
Has any insurer ever refused renewal, declined/cancelled cover or imposed any special terms?	Yes     No
If yes, please provide details: (e.g. details/reason for any insurance refused/ cancelled/special terms imposed, etc.)
Have you, or any other partner or director ever been declared bankrupt or insolvent or been the director of a company which has become insolvent or which has gone into liquidation, receivership or administration?	Yes     No
If yes, please provide details: (e.g. circumstances of bankruptcy/insolvency/administration etc.)
Date of bankruptcy/insolvency/liquidation/administration:
Amount of bankruptcy/insolvency, etc. (£'s):
Please provide details of date discharged, or please confirm if still current/outstanding:	Please note we are unable to provide a quote if your bankruptcy is not discharged or your CCJ / IVA remains outstanding or unsettled.
Have you, or any other partner or director ever had any County Court Judgements (CCJ's), or Sheriff Court Decrees?	Yes     No
If yes, please provide details: (e.g. type and circumstances of CCJ/Sheriff Decree)
Date of CCJ / Sheriff Decree:
Amount of CCJ / Sheriff Decree (£'s):
Is the CCJ / Sheriff Decree still current/outstanding?	Yes     No
Have you, or any other partner or director ever been prosecuted under any Health & Safety Legislation or ever been served a prohibition order or improvement order by the Health & Safety Executive?	Yes     No
If yes, please provide details of the prosecution(s):
Date of prosecution and/or prohibition/improvement order:
Details of any fines and/or action taken by the HSE: (Please enter 'None' if you no further action was taken)
Have you, or any other partner or director ever been the subject of a recovery action from HM Customs and Excise or the Inland Revenue?	Yes     No
If yes, please provide details: (i.e. name of person or business subject to recovery action, date of recovery action, and reason for the recovery action)
Trade Associations
Are you a member of a relevant trade association for your industry and/or any pre-qualification schemes (e.g. CHAS, Construction Line, Safe-Contractor, etc.)? (You may receive additional discounts if you are a member)	Yes     No
If yes, please provide details:
Trade / Work Undertaken
Description of your full trade / work activities undertaken: (Please describe as fully as possible including a percentage split between each activity, where you carry out more than one activity)
Work Locations
What percentage of your work is carried out on, or at the following premises/locations:
(i) Private Dwelling Houses and Flats?	%
(ii) Commercial Buildings (e.g. shops, offices, pubs, etc.)?	%
(iii) Industrial Buildings (e.g. industrial units, factories, etc.)?	%
(iv) Other Premises/Locations (state below if applicable)	%
Total:	100%
Is work carried out at any hazardous locations? (e.g. offshore installations, railways, motorways, bridges, tunnels, flyovers, viaducts, power stations and/or nuclear installations, refineries, petrochemical installations, or chemical works, oil or gas refineries or bulk storage facilities, airports, aircraft or airfields, quarries, mines, ships, docks, jetties, piers, dams, reservoirs, coastal defence or flood prevention, towers, steeples, chimney shafts and blast furnaces.)	Yes     No
If yes, please state type of location(s) and the percentage of work spent at the location(s):
Work Outside UK
Is any work undertaken outside the UK?	Yes     No
If yes, please provide details: (i.e. area(s) worked and percentage of turnover)
Professional Risks
Do you provide any advice, design or specification?	Yes     No
Trading Experience
How many years has your business been trading?	Please Select 0 years 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years 18 years 19 years 20 years 21 years 22 years 23 years 24 years 25 years 26 years 27 years 28 years 29 years 30 years 30+ years
Number of years previous experience in this trade: (A minimum of 3 years previous experience is required if you have 0 years trading)	Please Select 0 years 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years 18 years 19 years 20 years 21 years 22 years 23 years 24 years 25 years 26 years 27 years 28 years 29 years 30 years 30+ years
As you have been trading 0 years, please provide details of how you gained your experience: (i.e. position (e.g. director / manager / supervisor / employee), type of business (e.g. construction), the name of the companies where experience was gained, abd details of any managerial experience)
Depth / Height Work
Please state the maximum depth you dig:	0 1 2 3 4 5 5+ metre(s)
If any work is below 3 metres, please provide details: (e.g. type(s) of contract(s)/work undertaken, and percentage of turnover that this work represents)
Do you undertake any piling, underpinning or basement excavation work?	Yes     No
If yes, please provide details of work undertaken: (i.e. piling, underpinning or basement excavation work, the type of properties worked on and the type of contracts undertaken)
What percentage of your overall work activities does this work represent (e.g. 10%)?	%
Is this work carried out by Bona Fide Sub-Contractors? (BFSC's are sub-contractors who carry out their part of the work without supervision and hold their own liability insurance.)	Yes     No (own employees)
Please state the maximum height worked:	0 5 10 15 20 25 30 35 40 45 50+ metre(s)
If any work is above 15 metres, please provide details: (e.g. type(s) of contract(s)/work undertaken, and percentage of turnover that this work represents)
Do you or your employees undertake any steel erection/structural steel work?	Yes     No
If yes, please provide details: (i.e. type of steel work undertaken)
What percentage of your turnover does the steel erection/structural steel work represent (e.g. 10%)?	%
Do you use slings, cradles, bosuns chairs, abseiling equipment or tower cranes? (not including cherry pickers and mobile platforms)	Yes     No
If yes, please provide details of equipment used and percentage of time it is used: (e.g. tower cranes - used 10% of time)
If working at height, do you use any hydraulic lifts/platforms, access plant or any other equipment? (including cherry pickers and mobile platforms)	Yes     No
If yes, please provide details of equipment used and percentage of time it is used: (e.g. cherry pickers - used 10% of time)
Scaffolding
Do you use a scaffolding sub-contractor?	Yes     No
Do you ever erect your own scaffolding?	Yes     No
If yes, type of scaffolding (e.g. tower, tied, etc.):
How often do you erect your own scaffolding?
What is the maximum height of the scaffolding you erect for your own use?	0 5 10 15 20 25 30 35 40 45 50+ metre(s)
Heat Details
Do your activities involve the use of heat? (e.g. blow lamps, blow torches, welding equipment, grinders, etc.)	Yes     No
If yes, please state all types of heat used: (e.g. blow lamps, blow torches, welding equipment, grinders, etc.)
Percentage of work that involves the use of heat:	0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 85% 85% 90% 95% 100%
Do you operate a 'hot work' permit system for heat applications?	Yes     No
Health & Safety
Do you have a written Health & Safety policy in force which is reviewed regularly and distributed to employees?	Yes     No
Do you carry out a full Health & Safety Risk Assessment at the contract site before commencing work?	Yes     No
Are written Method Statements prepared for each contract?	Yes     No
Is Health & Safety training given to employees and is the training recorded?	Yes     No
Do you supply and enforce use of Personal Protective Equipment (PPE) where required?	Yes     No
Do you use an external Health & Safety Consultant?	Yes     No
If yes, name of Health & Safety Consultant?
Asbestos / Hazardous Substances
Do you or your employees work with asbestos, silica, explosives or any other substances hazardous to health?	Yes     No
If yes, type of hazardous substance: (i.e. non-notifiable asbestos, silica, etc.)
What percentage of your overall work activities does this work represent (e.g. 5%)?	%
Is this work carried out by Bona Fide Sub-Contractors? (BFSC's are sub-contractors who carry out their part of the work without supervision and hold their own liability insurance.)	Yes     No (own employees)
Demolition Work
Do you or your employees carry out any separate demolition work on buildings or structures other than as part of a contract for reconstruction, alteration or repair?	Yes     No
If yes, please provide details of the demolition work:
Percentage of your turnover involving separate demolition work?	%
Does your work involve hand demolition?	Yes     No
Does your work involve machine demolition?	Yes     No
Does your work involve ball and chain method?	Yes     No
Does your work involve one drop / felling method?	Yes     No
Does your work involve the use of explosives?	Yes     No
What is the maximum height of properties you demolish? (e.g. 15 metres)	metres
Fixed Woodworking Machinery / Timber Framed Buildings
Does any of your work involve the use of fixed woodworking machinery? (hand held power tools are acceptable)	Yes     No
If yes, please provide details: (i.e. No. of employees using the machinery and annual wages of the employees using the machinery)	No. of employees: Estimated wages:£
Will your activities involve the construction or renovation of timber framed buildings and/or the installation of timber cladding within the next 12 months?	Yes     No
If yes, please confirm the approximate percentage of your turnover that this work represents?	%
What is the maximum number of storeys in any one timber framed structure/block?	1 2 3 4 5 6 6+ storey(s)
What is the largest value of any one timber framed structure/block?
If you work on multiple blocks of flats or private dwelling houses, what is the minimum distance between them?	metres
Does the site and work comply with the Joint Code of Practice for construction sites?	Yes     No
How many years previous experience do you have working on timber framed structures?	0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 30+ year(s)
Builders / Property Developers Only
If your trade or business is a builder or property developer, please state the percentage split of your work:
New Construction up to 20m height:	%
New Construction up to 10m height:	%
General Building (i.e. alteration, maintenance, repairs, etc.):	%
Other Building Work (state below if applicable)	%
Total:	100%
Turnover
Estimated contracting turnover for the next 12 months:
Claims History
In relation to this business or any other previous business in which the proprietor or any partners or directors have traded, in this or any other name, has there been a claim under any of the cover(s) within the last 5 years?	Yes     No
Claim 1.
Date of Loss:
Cause of Loss:	- - - - - - - - Please Select - - - - - - - - Accidental Damage Aircraft and Other Aerial Devices Assault Employee Injury Escape of Beverages Escape of Oil Escape of Water Fire Fire (Arson) Flood Food and/or Drink Poisoning Fraud or Dishonesty of Staff Health and Safety Legislation Impact - Own Vehicle Impact - Third Party Legal Costs and Expenses Lightning Loss of Licence Malicious Damage Other Personal Injury Property Damage Pollution Professional Indemnity Replacement of Locks Robbery or Attempted Robbery Sprinkler Leakage Storm Subsidence, Ground Heave, Landslip Terrorism Theft or Attempted Theft Third Party Injury Third Party Property Damage Underground Services Damage
Circumstances of the Loss:
Total Cost of Loss (£'s): (including any amounts paid or outstanding)
Status of Claim:	Settled     Claim Still Pending
Do you wish to add another claim?	Yes     No
Claim 2.
Date of Loss:
Cause of Loss:	- - - - - - - - Please Select - - - - - - - - Accidental Damage Aircraft and Other Aerial Devices Assault Employee Injury Escape of Beverages Escape of Oil Escape of Water Fire Fire (Arson) Flood Food and/or Drink Poisoning Fraud or Dishonesty of Staff Health and Safety Legislation Impact - Own Vehicle Impact - Third Party Legal Costs and Expenses Lightning Loss of Licence Malicious Damage Other Personal Injury Property Damage Pollution Professional Indemnity Replacement of Locks Robbery or Attempted Robbery Sprinkler Leakage Storm Subsidence, Ground Heave, Landslip Terrorism Theft or Attempted Theft Third Party Injury Third Party Property Damage Underground Services Damage
Circumstances of the Loss:
Total Cost of Loss (£'s): (including any amounts paid or outstanding)
Status of Claim:	Settled     Claim Still Pending
Do you wish to add another claim?	Yes     No
Regrettably we will be unable to provide a quotation if you have had more than 2 claims.

Details of Cover Required
Public/Product Liability Cover
Is Public/Product Liability required?		Yes     No
Public/Product Liability limit of indemnity required:		£1 Million £2 Million £5 Million £10 Million
		Manual Principals		Managerial / Clerical Principals
Number of Proprietors/Partners/Company Directors:	No.		No.
Annual Wages of Proprietors/Partners/Co. Directors:
Please confirm your annual payments to Bona Fide (supply & fix) Sub-Contractors: (BFSC's are sub-contractors who supply their own materials and hold their own liability insurance.)
If you use Bona Fide Sub-Contractors, do you check they have the same level of liability insurance?		Yes     No     N/A
Employers' Liability Cover (Compulsory by Law if you have employees or use labour only sub-contractors)
Is Employers' Liability required? (£10M standard limit of indemnity)		Yes     No
		Manual Workers		Non-Manual / Clerical Workers
Number of Employees/Labour Only Sub-Contractors: (Do not include proprietors, partners and directors)	No.		No.
Annual Wages of Drivers and/or Yardsmen:
Annual Wages of Site Supervisors:
Annual Wages of all other Direct Employees (PAYE):
Annual Payments to Labour Only Sub-Contractors: (LOSC's are sub-contractors who supply labour only (not materials) and work under your supervision)
Employers' Reference Number (optional)
Employers' Reference Number (ERN) (if available):		(e.g. 123/AB12345 or 'Exempt')
Contract Works
Do you require cover for Contract Works? (i.e. the permanent / temporary works and materials on site)		Yes     No
Please state the maximum value of any one contract: (This amount will normally be less than and no more than your annual turnover.)
Please state the maximum length of any one contract: (e.g. typically up to a maximum of 6 or 12 months)		1 month 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11 months 12 months 15 months 18 months 24 months Over 24 months
Historical / Grade Listed / Mill Buildings
Do you undertake any work on historical, grade listed or mill buildings?		Yes     No
If yes, please provide details: (i.e. the type of building(s) worked on)
Percentage of turnover that involves work on historical, grade listed or mill buildings:		0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 85% 85% 90% 95% 100%
Site Security Details
Do you erect full site perimeter fencing and/or boarding at the contract site?		Yes     No
Please provide details of any additional security used to secure any materials or plant on site: (e.g. security patrols, plant/tools kept in locked building, CCTV, etc.)
Interested Parties
Do you require any interested parties noting on the policy?		Yes     No
Name of interested party:
Interested party address:
Nature of interest: (e.g. mortgagee, etc.)
Development land address (if applicable):
Own Plant
Do you require cover for Own Plant?		Yes     No
Please confirm the total value of your Own Plant, Tools & Equipment required to be covered whilst working on site:
Please confirm the maximum value of any one item of your own plant:
Employees' Tools
Do you require cover for Employees' Tools?		Yes     No
Please confirm how much cover you require for your Employee's Tools:
Hired-In Plant
Do you require cover for Hired-In Plant?		Yes     No
Please confirm the hired-in plant total value for all items of hired-in plant:
Please confirm the maximum value of any one item of hired-in plant:
Your estimated annual hiring charges/costs incurred: (e.g. £10,000 per annum)		per annum
Site Huts / Temporary Buildings
Do you require cover for Site Huts / Temporary Buildings?		Yes     No
Please state how much cover you require for site huts / temporary buildings:
Business Legal Expenses Cover
Do you require Business Legal Expenses Cover? (£100K standard limit for legal defence costs, employment disputes, tax investigations, etc.)		Yes     No
Limit of indemnity required?
Has the business been involved in any legal disputes, employment disputes or tax investigations in the last 5 years?		Yes     No
If yes, please provide details: (e.g. date of dispute, type of dispute outcome of dispute cost involved, etc.)
Directors & Officers Cover
Do you require Directors & Officers Cover?		Yes     No
Can you confirm that the company is domiciled in the UK; is privately held; has not raised any funds from external parties; has been in operation for more than 12 months; has its financial statements prepared by a qualified accountant, shows a profit and are not subject to any concerns by the auditors; derives at least 50% of all its turnover from clients within the UK and EU; has not acquired any companies which have increased its total assets by 50% or more; and has no mergers or acquisitions planned and has not had any claims made against it or its directors and is not aware of any circumstances that could give rise to such claim?		Yes     No
If no, details:
Limit of indemnity required?		£100,000 £250,000 £500,000 £1,000,000 £2,000,000 £5,000,000
Additional Information / Cover
If there is any additional information that you wish to disclose or cover that you wish to include, please provide details:
You are required to make a fair presentation of the risk to insurers which means that you are required to disclose every material circumstance which you know or ought to know relating to the risk to be insured. Materially important information is any information that could influence an insurer's decision to accept your risk including the cost of your insurance. Failure to comply with the duty of fair presentation could mean that your policy is void or that insurers are not liable to pay all or part of your claim(s). By submitting this quotation you are confirming that there are no other material facts to disclose other than those shown above.
Details Of Current / Previous Policies
Renewal date / date cover required:
Current renewal premium / best quotation:		This may help us to get you a better quote
Name of current / previous insurer:		e.g. Aviva, AXA, Allianz, RSA, Thistle, Zurich, etc.

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Disclosure
Please ensure that all the information you have provided is correct and that you have answered all the questions accurately then press the Request Contractors All Risks Quotation button and we will contact you shortly with a quotation.

Estimated Quote Time: 1 to 4 working days