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Shop / Office Insurance

Complete this form and submit for a really competitive quote.

Date Cover to Start:
(dd/mm/yy)
Name:
Trading Name:
Date Business Est:
Address:
Town:
County:
Postcode:
Contact Number:
Contact Fax:
Email:
Description of Trade:
No Of Employees:
Do you require buildings cover?
(yes/no)
Is the building of standard construction?
(yes/no)
Sum Insured?
Subsidence:
(yes/no)
Accidental Damage:
(yes/no)
Glass Cover:
(yes/no)
Sum Insured
Do you require contents cover?
General Contents?
Fixtures and Fittings?
Business Electronic Equipment?
Stock?
Tobacco?
Wines & Spirits?
Video Tapes?
Any claims?
(yes/no)
Any convictions?
(yes/no)
Alarm?
(yes/no)
What Type?
Previous Insurer?
Renewal Date:
(dd/mm/yy)
Renewal Premium:

 

 
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We are Bridges Insurance Brokers Ltd. Trading as Bridge Insurance Brokers. Registered in England No. 1066
Bridges Insurance Brokers Limited is authorised and regulated by the Financial Services Authority.

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