Lloyd Manley Associates - Shop Enquiries

Please complete the following Shop Enquiry form

General:
Company Name:
Address 1:
Address 2:
Post Code:
Telephone:
E-mail:
Business description:
Type of Firm:
	Limited Company
	Partnership
	Sole Trader
When established:
Annual Turnover:	£
Have you had any claims in the last 5 years:	Yes No
If Yes, please give details:
Premises:
Are your premises detached?	Yes No
Are your premises in an Arcade or Shopping Centre?	Yes No
Non combustible construction?	Yes No
Do you have an intruder alarm?	Yes No
Sums Insured:
Buildings:	£
Stock of High Risk Items: (Cigarettes, tobacco, wines, spirits, precious metals and stones, non-ferrous metals & portable hand tools)	£
Other Stock:	£
Computers & Electrical Office Equipment:	£
Other Business Equipment:	£
Frozen food:	£
Trade Specific Questions:
Do you require cover for work away from your premises other than collection or delivery?	Yes No
Do you require cover for Treatment Risk?	Yes No
If 'Yes' number of staff for cover:
Do you have Sun Beds?	Yes No
If 'Yes' how many:
Do you hire out equipment?	Yes No
If 'Yes' what type:
Loss of Revenue:
Do you need an indemnity period longer than 12 months?	Yes No
If 'Yes', how long
Your name:	Position:

Authorised and Regulated by the Financial Services Authority for General Insurance Business No. 302600