Lloyd Manley Associates - Small Contractor Enquiries

Please complete the following Small Contractor 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:
Tools:
Do you require cover for portable tools?	Yes No
Is cover required for tools in vehicles overnight?	Yes No
Limit required:	£
Employees:
Clerical, Admin & Sales only: Number of employees
Manual workers: Number of employees
N.B. if you use labour only subcontractors these must be treated as employees.
Do you use fixed woodworking machinery?	Yes No
Do you use heat equipment away from your own premises?	Yes No
Do you employ Supply and Fix sub contractors?	Yes No
If Yes, what trades and estimated payments:
Do you work in manufacturing premises for the following industries: Petrochemical, Pharmaceutical, Aviation, Marine, Automotive, Oil, Gas or Nuclear?	Yes No
Your name:	Position:

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