.:Oliver Wright Personal Financial Planning, New Ollerton:.

Date cover is required from:

Name		Trading as
Email address		Telephone
Business address		Post code
Period of time in business		Type of business/nature of work
Does anyone live at the premises?	Yes No
Is there an alarm at the premises?	Yes No
Is it NACOSS approved?	Yes No
What type of alarm is it?
What type of security is there on the external doors?
What type of security is there on the windows?
Type of wall construction
Type of roof construction
Have you had any insurance refusals in the past?	Yes No
If yes, please supply details
Cover required
Buildings		Public liability
Fixtures and fittings		Products liability
Glass		Employers liability
Stock		Est. annual wage roll
All risks		Est. annual turnover
Wines & spirits		Business interruption
Cigarettes & Tobacco		Loss of licence
Frozen food		Personal accident & assault
Money		Goods in transit
		Failure of extractor unit
Is accidental damage cover required?	Yes No
Have you had any previous claims or criminal convictions?	Yes No
If yes, please provide details
Please add any further relevant points to ensure we provide an accurate quote for you.

'Authorised and regulated by the Financial Services Authority'
Firm reference no : 300051