| Shop Insurance Quotation |
(* denotes required field) |
Proposers Name:* |
|
Correspondence Address:* |
|
Risk Address - As Above (Otherwise Specify):
|
|
Contact Name: * |
|
Contact Number:* |
|
Contact Mobile: |
|
E-Mail Address: |
|
Fax: |
|
Business Description: |
|
| If other please describe: |
|
Date Established: |
|
Do you reside on the premises: |
Yes
No
|
If Yes, home contents: |
€
|
Details of any other occupants sharing premises:* |
|
Hours of Business:* |
|
Do you serve food/drink for consumption on the premises: |
Yes
No
|
If yes, seating capacity: |
|
Construction of Walls:* |
|
Construction of Floors:* |
|
Construction of Roof:* |
|
Claims in last five years
(Date, Description, cost, finalised):* |
|
Fire Extinguishers: |
Yes
No
|
Fire Alarm: |
Yes
No
|
Monitored/Linked: |
Yes
No
|
Intruder Alarm: |
Yes
No
|
Monitored/Linked: |
Yes
No
|
CCTV: |
Yes
No
|
In Store ATM: |
Yes
No
|
Roller Shutters: |
Yes
No
|
Safety Statement: |
Yes
No
|
Existing Insurer: |
|
Premium: |
|
Date of cover: |
|
Property Cover (Material Damage All Risk including Theft Glass) |
Buildings: |
€
|
Fixtures, Fittings & all Other Contents:* |
€
|
Tenants improvements: |
€
|
Garage Canopy: |
€
|
Fuel Pumps: |
€
|
Car Wash: |
€
|
Petrol/Diesel in underground tanks: |
€
|
Cigarettes tobacco: |
€
|
Wines Spirits: |
€
|
General Stock:* |
€
|
Frozen Foods (Automatically €25,000, otherwise specify): |
€
|
Business Interruption/Loss of Profits Cover (Based upon 12 month period - if longer required specify period - automatically €1,000,000, otherwise specify) |
Gross Profit: |
€
|
Annual Rent (if applicable): |
€
|
Employers Liability - Limit of Indemnity €13 Million |
Annual Wages - Clerical Staff:* |
€
|
Annual Wages - Shop Assistants: |
€
|
Annual Wages - Property Repairs
(Including provision for temporary direct labour): |
€
|
Total Number of employees:* |
|
Public Products Liability - Limit of Indemnity €6.5 Million |
Annual Turnover: |
€
|
Cash Cover |
Cash in transit to/from Bank
(Automatically €20,000 otherwise specify): |
€
|
Cash on premises during business hours
(Automatically €20,000 otherwise specify): |
€
|
Cash out of hours in safe
(Automatically €20,000 otherwise specify): |
€
|
Details of Safe: |
|
Additional Information: |
|
|
01- 8366663
01 - 8555010
info@tis.ie