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)
Trading name:(if different to the above)
Trading status:
- - - - - Please Select - - - - -
Sole Proprietor
Partnership
Ltd. Company
Limited Liability Partnership
Other
Restaurant address:
Restaurant postcode:
Is the correspondence address different to the restaurant 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.
Have you, or any other partner or director ever been convicted of or charged with any criminal offence? Yes No
If yes, please provide details:(i.e. date of conviction, type of conviction, length of custodial sentence, etc.)
Have you, or any other partner or director ever had any county court judgements / sheriff decrees or been declared bankrupt, or involved in a company which has become insolvent or which has gone into liquidation, receivership or administration? Yes No
If yes, please provide details:(i.e. date of bankruptcy/insolvency, amount of bankruptcy/insolvency, whether discharged, etc.)
Has any insurer ever refused renewal, declined, cancelled or imposed special terms in respect of your restaurant insurance? Yes No
If yes, please provide details:(i.e. name of insurer, reason for refusal/special terms, etc.)
Have you, or any other partner or director ever been prosecuted under the Consumer Protection Act, Food Safety Act, or Health & Safety Act? Yes No
If yes, please provide details:
Can you confirm that you meet all the Statutory obligations; including fire safety, electrical inspections, Health & Safety and COSHH regulations, relating to the operation of your business? Yes No
About the Business
Business description (e.g. restaurant, take-away, etc.) :
Cafe (Incl. Deep Fat Frying)
Cafe (No Deep Fat Frying)
Cafe (Not Sandwich Bar)
Coffee Shop/Tea Room
Delicatessan (Includes cooking)
Eating Establishment
Fish £ Chip Shop (Excludes Restaurant)
Fish £ Chip Shop (Includes Restaurant)
Internet Cafe
Juice Bar
Other
Restaurant (Licensed)
Restaurant (Unlicensed)
Sandwich Bar
Take Away Foods (With Frying Range)
Take Away Foods (Without Frying Range)
Type of food served (e.g. indian, chinese, etc.) :
What is your Food Hygiene Rating?
5 Stars
4 Stars
3 Stars
2 Stars
1 Star
Not Yet Rated
Do you provide a take-away service from the premises? Yes No
What percentage of your turnover is derived from providing take-away food?
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Is a delivery service available from the premises? Yes No
If yes, please state percentage of turnover for delivery:
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Year Business Established
In what year was the business established? (yyyy)
If a new venture, please state the number of years previous experience (if applicable) :
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)
Opening Times
Will the premises be closed for any part of the year? Yes No
If yes, please provide details:
What time is the restaurant open until (e.g. 11pm)
Is there an ATM at the restaurant? Yes No
Construction Details
Construction of walls (e.g. brick, stone, etc.) :
Construction of roof (e.g. tile, slate, felt, etc.) :
If there any flat roofing? Yes No
Please confirm percentage flat roofing: %
Please confirm the type of flat roofing:(e.g. 'felt on wooden base' or 'concrete flat roof')
Construction of floor(s):
Both Timber and Concrete
All Concrete
All Wooden
Other
Is there a basement or a cellar? Yes No
Approximately, what year was the property built? (yyyy)
Is the property a grade listed building?(i.e. grade I, II, etc.)
Not Listed
Grade I
Grade II
Grade II*
Grade A
Grade B
Grade C
Please indicate the distance to the nearest watercourse, river, canal, lake, sea, coast, etc.:(e.g. 250 metres)
Has there ever been any subsidence damage or flooding at the premises or nearby? Yes No
If yes, please provide details:(i.e. date of damage, amount of damage, type of damage, etc.)
Additional Information
Are the premises licenced to sell alcohol? Yes No
How many seats are there in the dining area?
Is there any 'live' entertainment carried out at the restaurant (e.g. karaoke, solo act, duo, disco, etc.) ? Yes No
If yes, state the type of entertainment:(e.g. karaoke, solo act, duo, disco, etc.)
If yes, how many times a week?
Do you charge an entrance fee? Yes No
Do you employ door staff? Yes No
If yes, are they Agency (sub-contract) door staff only? Yes No
Details of any other facilities at the restaurant:(e.g. children's play areas, function rooms, etc.)
Is the restaurant in a good state of repair? Yes No
If no, please provide details:
Is your portion of the building entirely self-contained and in your sole occupation? Yes No
If no, please provide details:
Heating
Is the property heated only by gas or oil central heating, electric storage heaters, or fixed gas or electrical appliances or other forms of fixed heating? Yes No
If no, please provide details of other heating:
Do you have any portable heating? Yes No
If yes, please provide details:(i.e. gas, oil, electric, etc. and Number of portable heaters)
Cooking Details
Do you use deep fat frying equipment? Yes No
If yes, please state the type of frying equipment:
- - - - - - - - - Please Select - - - - - - - - -
Shallow pan frying and/or woks
Freestanding Fryer up to 6 litres
Freestanding Fryer up to 10 litres
Freestanding Fryer up to 40 litres
Freestanding Fryer over 40 litres
Full frying range
If any fryer exceeds 10 litres capacity, please confirm the age of the equipment: years
How often is the frying equipment competently serviced?
- - - - - - - - - Please Select - - - - - - - - -
Never
Every 6 months
Every 12 months
Less frequently than every 12 months
How often are the extraction systems and ducting cleaned by professionals?
- - - - - - - - - Please Select - - - - - - - - -
N/A (no ducting/extraction)
Never
Every 6 months
Every 12 months
Less frequently than every 12 months
Fire Safety
Is there a fire alarm at the premises? Yes No
If yes, is the fire alarm manual or automatic?
Manual
Automatic
Type of fire alarm signalling:
Audible - bells or siren
Monitored - central station
Do the premises have a sprinkler system installed? Yes No
Please state the specification of the system:(e.g. 28th edition, 29th edition, etc.)
Security
Are the premises occupied by the owner / manager overnight? Yes No
Are all your external doors fitted with a minimum of 5 lever mortise deadlocks (BS3621) or equivalent? Yes No
Are all opening windows fitted with key operated window locks? Yes No
Is the restaurant protected by an intruder alarm? Yes No
If yes, is the alarm NACOSS / NSI approved?
Please Select
No
Yes
Unknown
Method of intruder alarm signalling:
- - - - - - - Please Select - - - - - - -
Audible - Bells or siren only
Digi-Comm - to Central Station
Dual-Comm to Central Station
Dialler to Proprietor/Manager
Redcare - to Central Station/Police
RedCare GSM to Central Station/Police
Does the alarm incorporate confirmable technology? Yes No
Is the alarm maintained annually under a maintenance contract? Yes No
Do the premises have CCTV? Yes No
Please confirm the coverage area of the CCTV:
Internal Only
Internal and External
External Only
None
Please provide details of any other security arrangements:(e.g. roller shutters, window grilles, CCTV, etc.)
Claims History
Have you, or any other director or partner (in this or any other trading name) suffered any loss, incident 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, etc.)
Cover
Level of cover required?
- - - - - - - - - Please Choose - - - - - - - - -
Standard Cover (fire, theft, flood, etc.)
Standard Cover & Accidental Damage
Is terrorism cover required? 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, rebuilding architects fees, etc.)
Is cover required for subsidence, heave or landslip? Yes No
Tenants Improvements (if renting the premises and required)
Do you require tenants improvement cover?(i.e. to insure improvements you have made as a tenant to the building's fixtures & fittings such as a new counter, suspended ceiling, partitions, lighting, decorations, etc.) Yes No N/A
If yes, please state the sum insured:
Contents / Fixtures & Fittings
Electronic equipment sum insured:(e.g. tills, computers, etc.)
All other contents / fixtures & fittings sum insured:
Property Away From The Restaurant
Is cover required for business equipment temporarily taken away from the premises? Yes No
All Risks Sum Insured (£'s):(i.e. total value of property away from the premises)
Type of property to be covered away from the premises:(e.g. laptops, digital camera's, etc. Please specify each item.)
Territorial area:
UK
Europe
Worldwide
Stock
Wines and spirits:
Tobacco, cigarettes & cigars:
All other stock sum insured:
Deterioration of frozen food
Deterioration of frozen food (if required) :
Glass
Fixed external glass sum insured:
Money
Money sum insured:(during business hours / in transit)
£0
£500
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
£8,000
£9,000
£10,000
Money sum insured:(out of business hours in a locked safe)
£0
£500
£1,000
£2,000
£3,000
£4,000
£5,000
£6,000
£7,000
£8,000
£9,000
£10,000
Good in transit
Goods in transit sum insured (if required) :
Do you require business interruption cover?(i.e. loss of profit following an insured event such as a fire, etc.) Yes No
Please confirm your annual gross profit:
Please advise the period of time you wish the cover to extend?(allow sufficient time for rebuilding/refurbishing and further time to resume normal trading) 12 months 24 months 36 months
Do you require cover for loss of liquor licence?(i.e. depreciation of the value of your premises) Yes No
If yes, please confirm the sum insured required (£'s):
Do you require cover for loss of book debts? Yes No
If yes, please indicate the maximum amount of debit balances outstanding at any one time (£'s):
Public / Product liability limit of indemnity:
£1,000,000
£2,000,000
£5,000,000
Is any Work Away from the premises carried out other than collection or delivery? Yes No
If yes, please provide details:(i.e. type of work and number of employees involved)
Turnover
Please confirm the annual turnover of your business:
Employers' Liability Insurance
Do you require employers' liability cover?(£10 million standard limit of indemnity) Yes No
Please confirm the total number of employee's:
Please confirm the total annual wages of the employee's: per annum
Employers' Reference Number (optional)
Employers' Reference Number (ERN) (if available) : (e.g. 123/AB12345 or 'Exempt')
Is commercial legal expenses cover required?(£100,000 legal defence costs for contract disputes, employment disputes, VAT investigations, etc.) 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:
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.
Renewal date / date cover required:
Current annual premium / best quote to beat: This may help us to get you a better quote
Name of current / previous insurer: e.g. Aviva, AXA, Allianz, QBE, RSA, Zurich, etc.