Food Manufacturers Insurance Quote Form

For UK Customers Only

Please insert your details here and one of our business insurance advisers will contact you shortly.

This form is designed for quotes for single premise food manufacturers insurance trading from commercial business premises only. Food Manufacturers Insurance policies are flexible policies designed to provide cover for manufacturers the sections of cover that you require i.e. contents/plant/machinery, buildings (optional), business interruption, public/product liability, employers' liability, money, goods in transit, legal expenses cover, etc.

If you have more than one premises or require assistance when completing this form, please phone us on 01623 641 386 and we will be happy to help.

Contact/Company Details

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)
Business Trading Name: (if different to the above)
Trading Status:
Are any subsidiary companies to be included under this insurance?	Yes No
If yes, please provide the name(s) and address(es) of any companies you wish to include:
Business Address:
Business Postcode:
Do you have a different correspondence address?	Yes No
Correspondence Address:
Correspondence Postcode:
Daytime 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

Have you or any partner or director ever been convicted of or charged (but not yet tried) with any criminal offence?	Yes No
If yes, please provide full details: (e.g. type/reason for conviction(s), date(s) of conviction(s), details of any fines and/or community service (if applicable), length of custodial sentence(s) (if applicable),etc.)
Have you, or any partner or director ever been declared bankrupt, insolvent, the subject of a winding up order or liquidation or the subject of any county court judgements or sheriff decrees?	Yes No
Please provide details: (e.g. date(s) of bankruptcy/insolvency/CCJ/IVA, amount of bankruptcy/insolvency/CCJ/IVA (£'s), date discharged, or please confirm if still current, circumstances of bankruptcy/insolvency/CCJ/IVA, etc.)
Have you, or any other partner or director ever been a director or partner of a company which has gone into insolvency, liquidation, receivership or administration?	Yes No
If yes, please provide details: (e.g. name of previous company, date(s) of insolvency/liquidation/receivership/administration, reason for insolvency/liquidation/receivership, etc.)
Have you, or any other partner or director ever been the subject of a recovery action by Customs and Excise or the Inland Revenue?	Yes No
If yes, please provide details:
Have you, or any other partner or director ever been prosecuted or received notice of intended prosecution under the Consumer Protection Act, Food Safety Act or similar legislation?	Yes No
If yes, please provide details:
Has any insurer ever refused renewal, declined/cancelled cover or imposed any special terms?	Yes No
Please provide details: (e.g. details/reason for any insurance refused/ cancelled/special terms imposed, etc.)
Year Business Established
In what year was the business established?	(yyyy)
Year established at your current address?	(yyyy)
Number of Years Experience (if a new venture)
Number of years experience (if a new venture):	years
Business Details
Full description of food products manufactured: (Please describe as fully as possible including any processes involved)
Premises Details
Type of premises operating from: (e.g. industrial unit, commercial building, retail premises, etc.) (Please note we are unable to quote for premises operating from home)
Type of area that the premises are located: (e.g. industrial estate, commercial estate, high street, rural, etc.)
Are the premises occupied solely by your business and are not multi-tenure? (A multi-tenure building is where more than one set of tenants or occupants, either utilise or occupy separate sections of any one building.)	Yes No
If no, please provide details: (i.e. Number of other businesses/tenants and description of work activities carried out by other businesses)
Are the areas / space used by other businesses fully self-contained with their own means of access?	Yes No
Is your portion of the building(s) self- contained with its own means of access:	Yes No
If No, please provide details:
Unoccupancy
Are any parts of the building at present unoccupied?	Yes No
Please provide details of unoccupancy: (i.e. percentage unoccupied, how long unoccupied, etc.)
Are the premises ever left unoccupied for more than 30 days?	Yes No
If yes, please provide details:
Are the premises in a good state of repair and maintained?	Yes No
Health & Safety
Do you have an up-to-date Health & Safety Policy?	Yes No
Is all the relevant PPE provided with the use enforced?	Yes No
Have you or any partner or director ever been prosecuted under the Health & Safety Act?	Yes No
If yes, please provide details:
Flood / Subsidence Details
Has the premises or any adjacent premises ever suffered from or shown any signs of subsidence or ground movement?	Yes No
Please provide details of the damage: (i.e. date of damage, details of repairs carried out, cost of damage, etc.)
Are there any trees and/or shrubs which are more than 5 metres high and within 10 metres of the premises?	Yes No
If yes, please provide details: (i.e. type of trees (e.g. oak, etc.), proximity to premises, max. height of tree(s), etc.
Have your premises or any other premises within 100 metres ever been affected by flooding?	Yes No
Please provide details of the damage: (i.e. date of flood damage, cost of flood damage, details of any flood defence measures taken, etc.)
Are the premises at least 250 metres away from the nearest river, lake, canal or tidal waters and not in an area designated as a high flood risk?	Yes No
If no, please provide details: (i.e. distance to watercourse, type of watercourse (e.g. river, canal, sea, etc.), high flood risk details, etc.)
Business Premises Construction Details
Type of Property:
If not detached, please provide details of the type(s) of business activities carried out by any adjoining premises (if applicable):
Is there full fire break separation from adjoining premises?	Yes No
Construction of Walls (e.g. brick, stone, etc.):
Construction of Roof (e.g. tile, slate, metal, etc.):
Do the premises have any Flat Roofing?	Yes No
If yes, percentage Flat Roofing:	%
Type of Flat Roofing (e.g. felt on timber, concrete, etc.):
Does the premises have walls or roofing containing any composite panels?	Yes No
Please specify the core of the composite panels: (e.g. mineral rock wool, glass fibre, modified phenolic foam, polyisocyanurate (PIR), polyurethane, expanded polystryrene (EPS))
Are the composite panels LPS 1181 approved?	Yes No
What percentage of the construction contains composite panels?	%
Does the premises have walls or roofing containing any combustible linings?	Yes No
If yes, please specify the type of combustible linings: (e.g. modified phenolic foam, polyisocyanurate (PIR), polyurethane, expanded polystryrene (EPS), etc.)
What percentage of the construction contains combustible linings?	%
Please state the number of storeys:
Number of storeys where the floor is of wooden construction?
Are there any basement floors or below ground level?	Yes No
Approximately what year were the premises built?	(yyyy)
Are the premises grade listed? (i.e. Grade I, II, etc.)	Yes No
If yes, please provide details:
Electrical Systems
Do the premises have a current IEE electrical certificate?	Yes No
Heating Systems
What is the main type of heating for the premises? (e.g. fixed heaters, radiators, etc. - Enter 'None' if no heating.)
Heating fuel type:
Do you use portable heaters?	Yes No
Please provide details of all portable heaters: (i.e. No. of heaters, type of heaters, and whether or not the heaters are guarded.)
Details of any other heating (if applicable):
Security Details
Are all your external doors fitted with a minimum of 5 lever mortise deadlocks that comply with BS3621?	Yes No
Are all opening windows fitted with key operated window locks?	Yes No
Are your premises protected by an intruder alarm?	Yes No
Is the alarm NACOSS/NSI approved?	Yes No Not Sure
Type of alarm signalling:
Does the alarm incorporate confirmable technology?	Yes No
Is the alarm under your sole control?	Yes No
If linked to a central station, please confirm level of police response (if known):
Is the alarm maintained annually?	Yes No
Please provide details of any other security arrangements: (e.g. roller shutters, window grilles, recorded c.c.t.v., security guarding, premises occupied overnight, etc.)
Fire Safety
Do the premises have a fire alarm?	Yes No
If yes, type of fire alarm signalling:
Do the premises have a sprinkler system installed?	Yes No
If yes, please state the specification (if known): (e.g. 28th Edition, 29th Edition, etc.)
Do you have any combustible stock or waste stored in the open?	Yes No
If yes, please provide details: (e.g. type of stock and distance from nearest building (e.g. 5 metres))
Do you ensure that all waste (including refuse) is swept up and bagged daily and removed from the premises and/or surrounding yards at least once per week?	Yes No
Trade Declarations
Does the business have in excess of 50 litres of flammable liquids not stored within a proprietary flammables cabinet or specially constructed store?	Yes No
Please provide details of the flammable liquids: (i.e. confirm type of flammable liquids and and volume/capacity of the liquids/gases kept)
How are the flammable liquids stored?
Do you run any machines or processes unattended when no employees are present within the building?	Yes No
Are any products produced for inclusion in another product, or for non-human consumption?	Yes No
Please provide details: (e.g. type of product and percentage of turnover this represents, etc.)
Does the manufacturing process involve the use of a naked flame?	Yes No
If yes, please provide details: (i.e. the process which involves the use of a naked flame)
Do you carry out any deep fat frying?	Yes No
Are the deep fat fryers protected by a fire extinguishing system?	Yes No
Cold Rooms
Are there any cold rooms?	Yes No
If yes, what percentage of the floor space is taken up by cold rooms?	%
Is the panelling LPCB approved?	Yes No
What is the type of insulation material in the panelling? (e.g. modified phenolic foam, polyisocyanurate (PIR), polyurethane, expanded polystryrene (EPS), etc.)
Storage
Is more than 25% of the floor area used for storage of raw materials and/or stock?	Yes No
If yes, please confirm percentage of floor area:
Is any storage more than 6 metres in height?	Yes No
Please provide details of storage above 6 metres: (i.e. how it's stored (e.g. racking, free-standing, etc.), and the maximum height it is stored at)
Are plastic and/or wooden materials or articles, flammable liquids, gases or hazardous chemicals used, stored or manufactured?	Yes No
If yes, please provide details: (i.e. type of flammable item(s), quantity/volume of item(s), any safeguarding measures in place, etc.
Claims History
Have you, or any other partner or director (in this or any other trading name) suffered any loss or had any claims made against you in the last 5 years?	Yes No
If yes, please provide details: (i.e. date of claim, description of claim, amount claimed £'s, etc.)

Property Cover

Level of Cover Required?
Is Sprinkler Leakage cover required?	Yes No
Do you wish to add cover for Terrorism?	Yes No
Buildings Cover (if owner occupied and required)
Buildings Sum Insured (if required): (reinstatement value including outbuildings and an allowance for demolition costs, removal of debris, architects' fees, etc)
Is subsidence, heave and landslip cover required?	Yes No
Tenants Improvements (if renting and required)
Tenants Improvements Sum Insured (if required): (i.e. to insure improvements you have made as a tenant to the building's fixtures and fittings such as a new counter, suspended ceilings, partitions, lightning, decorations, etc.)
Contents
Plant/Machinery/Contents Sum Insured: (excluding computers/electronic equipment)
Computers/Electronic Equipment Sum Insured:
Stock
Trade Stock within the premises: (excluding 'High Risk/Target' stock such as audio/visual equipment, cigarettes/cigars/tobacco, computer equipment/tablets, computer games, mobile phones, non-ferrous metals, precious metals, jewellery/watches, photographic equipments/binoculars, wines, fortified wines & spirits & explosives.)
Do you have any 'High Risk/Target' stock? (e.g. audio/visual equipment, cigarettes/cigars/tobacco, computer equipment/tablets, computer games, mobile phones, non-ferrous metals, precious metals, jewellery/watches, photographic equipments/binoculars, wines, fortified wines & spirits & explosives.)	Yes No
High Risk/Target Stock Sum Insured:
Type of High Risk/Target Stock:
Stock in the Open
Stock kept outside in the open:
Deterioration of Frozen Food
Do you require cover for deterioration of frozen food?	Yes No
Please state the freezer contents sum insured: (i.e. total for contents of all freezers)
Number of refrigeration units:
Maximum age in years of any of the fridge/freezers?	years
Maximum value of contents in any one fridge/freezer?
Business All Risks
Do you require 'All Risks' cover for property/items in and away from the premises? (e.g. laptops, mobile phones, digital cameras, tablets, etc.)	Yes No
All Risks Item 1
Item description:
Sum insured:
Single item limit:	(Max. £5,000 single item limit)
Area of cover:

Do you wish to add another 'All Risk' item?	Yes No
All Risks Item 2
Item description:
Sum insured:
Single item limit:	(Max. £5,000 single item limit)
Area of cover:

Do you wish to add another 'All Risk' item?	Yes No
All Risks Item 3
Item description:
Sum insured:
Single item limit:	(Max. £5,000 single item limit)
Area of cover:

External Glass & Signs Cover (if required)
External Fixed Glass:
External Signs and Blinds:
Money Cover
Is money cover required?	Yes No
Money cover during business hours/in transit:
Money cover out of business hours in a locked safe:

Liability Cover

Public Liability
Is public liability cover required?	Yes No
If yes, please choose limit of indemnity: (if greater than £1M limit of indemnity)
Is all machinery properly fenced, guarded, maintained & in good order?	Yes No
Do you handle or use any hazardous substances? (e.g. radioactive/explosive substances, toxic chemicals/acids, asbestos, silica, etc.):	Yes No
If yes, details of hazardous substances used:
If yes, details of precautions used: (e.g. overalls, gloves, safety glasses, suitable work boots, trained personnel only to handle hazardous substances, etc.)
Does any of your work produce noise levels over 85dB(A)?	Yes No
If yes, details of precautions used: (e.g. ear defenders, etc.)
Do you carry out any work away from your premises? (other than collection or delivery)	Yes No
Work Away Activities
Please describe the work activities carried out away from your premises:
What percentage of your turnover does this work represent?
Do you work at any hazardous locations away from your premises? (e.g. airports, docks, dams, reservoirs, lakes, rivers, mines, quarries, tunelling, mining, chemical works, gas works, oil refineries, nuclear installations, offshore installations, or bulk oil, petrol, gas or chemical storage tanks, towers, steeples, chimney shafts, bridges, viaducts, railway, motorways, etc.)	Yes No
If yes, please provide details: type of the locations, the type of work carried out, and the percentage of your turnover at theses locations, etc.)
Do any of your activities away from the premises involve the use of heat? (e.g. blow lamps, welders, oxy-acetylene, grinders, etc.)	Yes No
Please confirm the the type of heat used: (e.g. welding, blow lamp, etc.)
Please confirm the percentage of time using heat (e.g. 10%):	%
Maximum Height Worked:
Maximum Depth Worked at:
Annual payments to bona-fide sub-contractors (if used): (BFSC's are sub-contractors who supply their own materials on site and hold their own insurance)

Product Liability
Is product liability cover required?	Yes No
If yes, please choose limit of indemnity: (This is normally the same as your public liability limit)
Please describe the food products being sold/supplied/manufactured:
Do you have offices, assets, representations or agents outside the UK?	Yes No
Will any of your products be supplied directly or indirectly to the USA/Canada?	Yes No
If yes, please confirm percentage of turnover:	%
Please confirm percentage of products, materials or components imported from the following regions (if applicable):
Europe:	%
Asia:	%
Australia/NZ/USA/Canada:	%
Rest of World:	%
Are any 'Hold Harmless' agreements in place?	Yes No

Turnover
Turnover of your business in the U.K. (£'s):
Turnover of your business in Europe (£'s):	Only complete if applicable
Turnover of your business in USA/Canada (£'s):	Only complete if applicable
Turnover of your business in Rest of the World (£'s):	Only complete if applicable

Product Recall
Do you require Product Recall cover? (Please note a £5,000 minimum premium applies to add this section of cover)	Yes No
Limit of indemnity required:

Employers' Liability (Compulsory by Law if you have employees or use labour only sub-contractors)
Is Employers' Liability cover required?	Yes No
Employers' Liability limit of indemnity:
Employers' Reference Number (ERN) (if available):	(e.g. '123/AB12345' or 'Exempt')

Wages/No. of staff - At the Premises
	Manual Workers	Non-Manual / Clerical Workers
Number of Principals/Partners/Company Directors:
Annual Wages of Principals/Partners/Co. Directors (£'s):
Number of Employees: (Do not include proprietors, partners and directors)
Annual Wages of Employees (£'s):

Wages - Work away from the Premises (if applicable)
Annual Wages of Principals/Partners/Co. Directors (£'s):
Annual Wages of Employees (£'s):
Annual Wages of Commercial Travellers/Salesmen (£'s):
Annual Wages of Employees 'working away' using heat (£'s): (e.g. using blow lamps, welders, hot air guns, grinders, etc.)

Business Interruption

Do you require Business Interruption Cover? (i.e. loss of profit/revenue following an insured event, e.g. fire, flood, etc.)	Yes No
If yes, please state the Gross Profit/Gross Revenue of your business (£'s):
If yes, please state the period of time you wish the cover to extend?	12 months 18 months 24 months 36 months (allow sufficient time for rebuilding/refurbishing and further time to resume normal trading)
Do you require cover for loss of Book Debts?	Yes No
If yes, please indicate the maximum amount of Gross Fees and Debit Balances outstanding at any one time (£'s):

Goods In Transit Cover

Do you require goods in transit cover?	Yes No
Own Goods
Do you required cover for carriage of own goods?	Yes No
Please state the total number of own vehicles for carriage of own goods:
Please state the maximum sum insured required per vehicle:
Territorial limit required:	UK EU USA & Canada Worldwide
Annual Sendings (UK)
Do you require cover for sendings within the UK?	Yes No
Haulage Contractors (if required)
Estimated annual carryings by haulage contractors?
Max. value any one consignment?
Rail (if required)
Estimated annual carryings by rail?
Max. value any one consignment?
Post (if required)
Estimated annual carryings by post?
Max. value any one consignment?

Fidelity Cover / Theft by Employees

Do you require cover for theft by employees?	Yes No
Please confirm the total number of persons employed:
Do you obtain written references confirming the integrity of employees?	Yes No
Do you have a system whereby you or at least two employees check stock, money and all other business records at least monthly?	Yes No
Aggregate limit of indemnity required:
Limit of indemnity for any one employee:

Commercial Legal Expenses Cover

Is commercial legal expenses cover required? (£100,000 limit of indemnity)	Yes No
Has the business and/or its directors been involved in any legal dispute, tax investigation or any other court or tribunal action in the last 5 years?	Yes No
Please provide details of the dispute including dates:

Management Liability Cover

Is directors and officers cover required? (Cover for any 'wrongful act' of a director or officer of the company)	Yes No
Limit of indemnity required?
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, please provide details: (i.e. reason for not being able to comply with above)

Professional Risks

Do you provide any advice, design or specification?	Yes No
If yes, do you require professional indemnity cover?	Yes No
If yes, limit of indemnity required?

Other Covers

If there is any additional information that you wish to disclose, or cover that you wish to include, please provide details: (e.g. engineering inspection, etc.)
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:	(dd/mm/yyyy)
Current renewal premium / best quote (£'s):	per annum (This will help us to get you a better quote.)
Name of current / previous insurer:	(e.g. Aviva, AXA, Allianz, QBE, RSA, Zurich, etc.)

Request Food Manufacturers Insurance Quotation

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 Manufacturers Insurance Quotation' button to send your quotation details to us.

Estimated Quote Time: 1 to 4 working days