GIB LETCOVER :: Insurance Solutions for Landlords and Property Owners
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Commercial Property Insurance Quote
Where did you hear about us?
If other please specify:
About you
Sex
Title
First Name
Surname
Company Name (if applicable)
Date of Birth
Marital Status
Occupation
Type of business
Email
Telephone Number
Is policy to be in joint names?
Joint Policyholder (if required)
Sex
Title
First Name
Surname
Date of Birth
Marital Status
Occupation
Type of business
Correspondence Address
Property Name / Number
Address
Postcode
Risk Address Details
Property Name / Number
Address
Postcode
Property type

Trade Type of Tenant

(if multiple tenants please list all trade types)
Is property part residential?
If 'yes' please advise type of tenant
Is any part of property owner occupied?
Is any part of property vacant?
Buildings Sum Insured
Contents Sum Insured
Do you want to extend cover to include Accidental Damage?
Do you require Loss of Rent cover?
If so, please advise total annual rent received for property
Do you require Propert Owners Liability cover?
Is so, please advise level of cover
Construction Details
Is the property built solely of brick, stone or concrete and is either flat roofed or roofed with slate, tile or concrete?
If no, please give details fo construction
If property has some flat roof, please state percentage & construction
Year of Build?
Year of Purchase?
Is property a listed building?
If so what grade?
Number of storeys?
Upper storey floor construction?
Is there a Sprinkler system installed?
Risk Statement
 

You or any other joint owners have never:

- Suffered any loss or incurred any liability, whether insured or not, during the last 3 years as a result of the risks proposed (whether at this or any other premises) or had any claims made against you?
- Been convicted of, or in the course of being charged with, any offence (excluding driving offences) whether at these premises or elsewhere?
- Been declared bankrupt or been a director of any company that went into liquidation?
- Had any insurance declined, cancelled, refused or had any special terms applied by any Insurer for the risks proposed?

The premises are:

- In a good state of repair and will be so maintained
- Heated solely by oil and/or electricity and/or mains gas and/or solid fuel
- Not close to cliff, quarry or other excavation
- Are not showing any sign of existing or previous damage by Subsidence, Heave or Landslip
- Free from any underpinning or any remedial action with regard to subsidence, heave or landslip
- Self contained with its own lockable entrance door from the street or landing
- In a position/area likely to be subject to flooding or where flooding has occurred
- NOT used for any hazardous processes or hazardous materials stored in or at the premises
- NOT having any structural alterations, or major renovation work affecting load bearing walls or the roof, or are any such works being planned
- NOT to be inactive, vacant, untenanted, unoccupied for a period exceeding 14 consecutive days?

Do you agree with the above statements?

If no, please state reasons why:
Claims Details
Please give FULL details of any claims made on either Buildings or Contents insurance within the last 5 Years
Date Cover to commence
Current renewal premium, if applicable
Current Insurer, if applicable
Additional Information

Please add any information you feel may affect the quotation.

 

Call us now on: 01279 429 024 or Fax: 01279 433 383

‘GIB LETCOVER ’ is a trading name of Gothic Insurance Brokers Ltd who are are authorised & regulated by the Financial Services Authority, Firm Number 300031
Registered Trading address : Gothic House, Station Road, Old Harlow, Essex, CM17 0AP