Quotation Request

Crown Insurance Consultants 01784 436262

PROPOSER DETAILS

Occupation/s within the Buildings

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

Subsidence
	Does the Proposer wish to extend cover to include subsidence?	Yes No

Building's Sum Insured
Declared Value at Inception (Â£)


Claims
Is loss of rent required?			Yes No
If yes, Amount of cover required Â£


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

* = Input is required