| What is the cost to rebuild
the buildings including outbuildings and
including allowance for architect and
surveyors fees. This is not the value, it is the cost to
rebuild. |
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| Replacement cost of house contents as new excluding those listed below |
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| All risks items for personal possessions
that require cover outside the home. Allowing
for all the family members please give the
maximum value that could be out of home at
one time but do not include individual items over £1500
which need to be specified (see below) |
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| If you require all risks cover on sports
equipment please give the maximum value that
could be out of your home at any one time |
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| If deterioration of freezer contents is
required please give number of freezers |
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| and the age of oldest freezer in full
years Cover will not be available for freezers over 10 years
old |
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| and the total value of frozen foods kept
in the freezers |
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| If you have any items of personal
possessions which exceed £1500 in value and
you want to have them insured in and out of
the home then please list them as Specified
All Risks Items below. Items which never
leave the home do not need to be included
here. You will need to let us have a
valuation of the items concerned. |
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| If there are any other item which need to
be specified, then please include these in
the notes section |
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| If you want to cover any push bikes
please list below |
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| If there are any extra push bikes please
add them into the notes section |
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| What are the walls made from |
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| What is the pitched roof made from |
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| If there is a flat roof give % of the
total roof area |
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| What type of home is it |
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| How many bedrooms does it have |
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| In which year was the house built |
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| Which bank or building society has an
interest |
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| Is the home unoccupied for over 30 days
in the year |
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| Is the home unoccupied during the working
day |
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| Do you take paying guests or is it a
holiday home or let |
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| Is it used for any professional purpose |
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| What is the insured's occupation |
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| What is the insured's spouse's occupation |
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| What is the insured's date of birth |
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| Has he or she been refused insurance |
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| Does any family member have non motor
convictions |
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| Is there a BS4737 Alarm installed If so
what type |
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| Is the accessible front elevation all
double glazed units |
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| Do all exit doors have 5 lever mortise locks |
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| Do all patio doors and accessible windows
have keyed operated locks. |
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| Do you have all accessible windows fitted with the SACS
Systems Ltd IPS-3G security locks |
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| Are there are suitably sited smoke
detectors |
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| Is your property in an area especially exposed to flood
or storm damage, or has it been damaged by water or storm
previously. If so please give full details in the notes
section. |
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| Are you members of an official
neighbourhood watch scheme |
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| How many claims or incidents have you had in the past 5 years prior to inception |
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| How many claims or incidents of subsidence or heave have you
ever had |
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| Please give full details of all claims in
the notes section |
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| Who are your existing insurers |
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| Who are your existing brokers or
intermediary |
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| How many consecutive years have you held
a policy without making a claim (We give no
claims discount) |
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| What is your existing insurers renewal
premium or what is your best premium Does
this include accidental damage cover?
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| Please enter any further message or notes
in this box |
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