BusinessInsuranceQuotations.com Block of Flats / Property Owners Insurance Form 1. Your Name (Insured Name) : 2. Correspondence Address :  Post Code:            Telephone Number:  E-mail address: 3. Property address: (if different from above)  Property postcode 4. Managing Agent Details: (if applicable)  Name  Address  Postcode  Phone 5. Property Details:  Buildings Sum Insured  Contents of communal parts - Sum Insured  Number of blocks  Number of flats  Number of storeys (incl ground)  Is the property purpose built or converted? Purpose BuiltConverted-  Approximate year built  Approximate year of conversion  Are the floors between properties timber?  Yes No  Are the stairs made of timber?  Yes No  Is the property listed?  Yes No  If yes, what grade?  CONSTRUCTION OF PREMISES (eg: Brick walls, Mild steel roof)  Is there a partial or full flat roof?  Yes No  If "Yes" describe in detail: (size, type, construction and age)  Is the property used for any business or commercial purposes?  Yes No  If yes, give details:  Are all the flats owner occupied?  Yes No  If not, please specify how many are -  Holiday homes  Let to professionals/retirees under Assured Shorthold Tenancies  Let to Local Authority  Let to DSS referrals  Let to students  Non-AST lets/under 6 months  Second non-letting holiday homes  Are any of the flats unoccupied?  Yes No  If some flats are unoccupied, please give details:  Are there any communal facilities such as a swimming pool or gym?  Yes No 6. INSURANCE HISTORY Please give details of any claims in the last five years: Date of claims What happened (eg fire, theft, storm, flood) Total Payment 1. 2. 3. 4.  Name of current insurers (so that we don't approach them!)  Expiry date of current insurance  Current premium (if known) £ If you require quotes for passenger lifts, please specify -    Number of lifts    Number of floors   Do you require Directors and Officers liability insurance?  Yes No If yes, Limit of indemnity for directors and officers:  Not Required£100,000£250,000£500,000£1,000,000Other- Automatic cover - Property Owners Liability of indemnity : £2,000,000 Employers' Liability - limit of indemnity : £10,000,000 Either Alternative Accommodation or Loss of Rental Income : 20% of the Building Sum Insured Please supply me with an estimate within 105 working days. (We will attempt to meet the target, but please be aware that it does require our insurers to respond quickly as well!) Done   Please check your details, and when you are happy that all is correct, tick the 'Done' box and then click the Submit button above...