Quotation Request

Crown Insurance Consultants 01784 436262

PROPOSER DETAILS

Additional Locations
When did the premises become unoccupied and what is its intended use

Construction
	Walls
	Floors
	Roof
	Is the building a modern architectural conversion?	Yes No


	Details of the works done or to be carried out

Covered Required
Subsidence
Does the Proposer wish to extend cover to include subsidence?			Yes No
Do you want to extend cover from fire, lightening, explosion and aircraft?			Yes No
Is the property to be demolished?			Yes No


Building Sum Insured
Declared Value at Inception (£)
	Additional buildings sum insured (As specified above)
	Claims details within the last 5 years


Security and Addiotional Information
Additional information that you wish to declare to help us obtain a competitive premium.

* = Input is required