Warehouse Insurance Quotation Form

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

This form is designed for quotes for businesses that require single premise warehouse insurance cover. If you have multiple warehouses you wish to insure, please phone us.

If you require assistance when completing this form, please phone us on 01623 641386 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:	- - - - - - Please Select - - - - - - Sole Trader Partnership Limited Company (Private) Limited Company (Plc) Limited Liability Partnership Charity Unincorporated Association
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:
Warehouse Address:
Warehouse Postcode:
Do you have a different correspondence address?	Yes     No
Correspondence Address:
Correspondence Postcode:
Daytime Telephone No.:
*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
Please provide details: (i.e. type of convictions, date of conviction, fine/length of sentence, 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: (i.e. date of bankruptcy/insolvency, amount, whether discharged, 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:
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:
Has any insurer ever refused renewal, declined/cancelled cover or imposed any special terms?	Yes     No
Please provide details:
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
Category of your primary business activities: (e.g. retailer, wholesaler, manufacturer, personal use, etc.)	Please Select Retailer Wholesaler Distribution Construction / Builders Tradesman Manufacturer Leisure Personal / Domestic Use Other
Please provide a full description of your primary business for which the warehouse is needed? (e.g. furniture retailer, ebay trader, clothing retailer, food & drink retailer, personal storage, etc.)
Please confirm the type of goods kept/stored at the premises:
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.
Premises Details
Please confirm the type of premises: (please amend if different to warehouse)
Are the premises fully attended during normal business hours?	Yes     No
If not, please advise when the premises are attended:
Type of area that the premises are located: (e.g. commercial, industrial, residential, rural, etc.)	Airside Arcade Business Park Covered Shopping Centre Commercial Estate High Street Industrial Estate Market Nuclear Installation Precinct Quarry Residential Area Rural Area
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
Have you or any partner or director ever been prosecuted under Health & Safety legislation?	Yes     No
Please provide details:
Subsidence / Flood 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, cost of damage, type 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 the premises ever been affected by flooding?	Yes     No
Please provide details of the damage: (i.e. date, cost of damage, circumstances, 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, high flood risk details, etc.)
Construction Details
Type of Property:	Please Select Detached Semi-Detached Terraced
If not detached, please provide details of the type(s) of business activities carried out by any adjoining premises:
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, 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 in the building:	1 2 3 4 5 6 7 8 9 9+
Number of storeys where the floor is of wooden construction?	0 1 2 3 4 5 6 7 8 9 9+
Are there any basement floors or floors below ground level?	Yes     No
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:	Grade I Grade II Grade II* Grade A Grade B Grade C
A.T.M.
Is there an A.T.M. cash machine on the premises?	Yes     No
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.)	Please Select Fixed Heaters Radiators - Hot Water Radiators - Oil Filled Night Storage Heaters Fire - Open Fire - Other Hot Air None Oil Heater Pressure Jet Heater Radiant Panel Heater Stove
Heating fuel type:	Please Select Electricity Gas Bottled Gas Heating Oil LPG N/A - No Heating Natural Gas Paraffin Solid Fuel Waste Oil Wood
Do you use portable heaters?	Yes     No
Number of portable heaters?	1 2 3 4 5 6 7 8 9+
Please provide details of the type of portable heaters: (e.g. fan heaters, oil filled radiators, etc.)
Where are the portable heaters located?	Office Areas Only Workshop Areas Only Both Office and Workshop Areas
Are all of the portable heaters guarded?	Yes     No
Are all portable heaters kept a minimum of 1 metre from combustible materials?	Yes     No
Are all portable heaters kept on non-combustible surfaces?	Yes     No
If no, please provide details:
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 ground floor and accessible 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:	Audible - Bells or Siren ABC Central Station Dial-up Line Central Station Direct Line Digi-Com to Central Station Dualcom to Central Station Dualcom Line To Site Security Office PAKNET Redcare Assure To Central Station Redcare Complete To Central Station Redcare GSM To Central Station Redcare Secure2 To Central Station Redcare Secure3 To Central Station Redcare Secure4 To Central Station
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):	Not Known Level 1 Level 2 Level 3 No Police Response
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:	N/A - No Alarm 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.)
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))
If yes, please provide details:
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
Do you run any machines or processes unattended when no employees are present within the building?	Yes    No
If yes, please provide details: (i.e. type of machines / processes left unattended and the time periods they are left unattended)
Storage
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)
Claims Experience
Have you or any other director or partner (in this or any other trading name) suffered any loss or had any claims made against you in the last 5 years?	Yes     No
Please provide details of claim(s): (i.e. date of claim(s), circumstances of claim(s), amount claimed, etc.)
Property Cover / Material Damage
Level of Cover Required?	Please Choose Fire & Special Perils Fire & Special Perils + Accidental Damage
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:	Please Select Audio/Video Equipment Computer Equipment Electronic Equipment Employee Personal Effects Exhibition Equipment Jewellery and Watches Machinery and Plant Mobile Phones Models Photographic Equipment and Binoculars Public Address (PA) Equipment Sports Equipment Survey Equipment Tablet Tools - Non Power Driven Tools - Power Driven Handtools Trade Samples Trophies
Sum insured:
Single item limit:	(Max. £5,000 single item limit)
Area of cover:	UK only EU only Worldwide
Do you wish to add another 'All Risk' item?	Yes     No
All Risks Item 2
Item description:	Please Select Audio/Video Equipment Computer Equipment Electronic Equipment Employee Personal Effects Exhibition Equipment Jewellery and Watches Machinery and Plant Mobile Phones Models Photographic Equipment and Binoculars Public Address (PA) Equipment Sports Equipment Survey Equipment Tablet Tools - Non Power Driven Tools - Power Driven Handtools Trade Samples Trophies
Sum insured:
Single item limit:	(Max. £5,000 single item limit)
Area of cover:	UK only EU only Worldwide
Do you wish to add another 'All Risk' item?	Yes     No
All Risks Item 3
Item description:	Please Select Audio/Video Equipment Computer Equipment Electronic Equipment Employee Personal Effects Exhibition Equipment Jewellery and Watches Machinery and Plant Mobile Phones Models Photographic Equipment and Binoculars Public Address (PA) Equipment Sports Equipment Survey Equipment Tablet Tools - Non Power Driven Tools - Power Driven Handtools Trade Samples Trophies
Sum insured:
Single item limit:	(Max. £5,000 single item limit)
Area of cover:	UK only EU only Worldwide
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
Please choose limit of indemnity required: (if greater than £1M limit of indemnity)	£1 Million £2 Million £5 Million £10 Million
Is all machinery properly fenced, guarded, maintained and 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 any of your activities at the premises involve the use of heat?	Yes     No
If yes, state the type of heat used (e.g. welding, etc.) and the percentage of time using heat:	Type Used: Percentage Used: %
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?	0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 85% 85% 90% 95% 100%
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 of the locations, the type of work carried out, and the percentage of your turnover at theses locations:
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:	None Up to 5 Metres Up to 10 Metres Up to 15 Metres Up to 20 Metres Over 20 Metres
Maximum Depth Worked at:	None Down to 1 Metres Down to 2 Metres Down to 3 Metres Over 3 Metres Down
Product Liability
Is product liability cover required?	Yes     No
Please choose limit of indemnity required: (This is normally the same as your public liability limit)	£1 Million £2 Million £5 Million £10 Million
Please describe the goods being sold/supplied/stored:
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:	%
Are any of the products intended for installation in or to form part of aircraft, water bourne craft, offshore installations, nuclear installations, petro-chemical works or power stations?	Yes     No
If yes, please provide details of the product(s) and the percentage of turnover that this represents:
Are any of the products intended for the automobile industry and/or motor vehicles?	Yes     No
If yes, please provide details of the product(s) and the percentage of turnover that this represents:
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):
Turnover of your business in USA/Canada (£'s):
Turnover of your business in Rest of the World (£'s):
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/Company Directors:
Annual Wages of Principals/Co. Directors (£'s):
Number of Employees: (Do not include proprietors, partners and directors)
Annual Wages of Employees (£'s):
Do any of your employees use fixed woodworking machinery?	Yes     No
Number of woodworking machine operators:
Annual wages for the fixed woodworking machine operators (£'s):
Wages - Away from the Premises
Annual Wages of Principals/Co. Directors (£'s):
Annual Wages of Employees (£'s):
Annual wages of commercial travellers/salesmen (£'s):
Work away using heat (£'s):
Business Interruption
Do you require Business Interruption Cover? (i.e. loss of profit/revenue following an insured event)	Yes     No
Please state the Gross Profit/Revenue of your business (£'s):
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
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?	£100,000 £250,000 £500,000 £1,000,000 £2,000,000 £5,000,000
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)
Additional Information / Other Covers
If there is any additional information that you wish to disclose or cover that you require, 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 / cover start date:
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.

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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 Warehouse Insurance Quotation button to send your quotation details to us.

Estimated Quote Time: 1 to 4 working days