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Catch All

Company Status

Day One Uplift

Building Landlord Interested Party

Employers Liability

Public Liability

Products Liability

Clerical

Manual Work at the Premises

Manual Work away from the Premises

Turnover UK & EU

Referred to Underwriters Yes No Select Yes or No

Referred Comment

Do you consider the client to be a vulnerable customer? Yes No Select Yes or No

Vulnerable category

...Sub category

Have all partners names been recorded ? Yes No Select Yes or No

Is your business based in the UK ? Yes No Select Yes or No

been convicted or charged with (but not yet tried), have any prosecution pending, or given an Official Police Caution in respect of any criminal or other offence other than a motoring offence or an offence that is now considered “spent” under the current Rehabilitation of Offenders Act? Yes No Select Yes or No

been convicted of, charged (but not yet tried) with or officially cautioned for a breach of any Health and Safety or Welfare or Environmental Protection legislation? Yes No Select Yes or No

been disqualified under The Company Directors Disqualification Act 1986 from holding a company directorship? Yes No Select Yes or No

had an insurance proposal declined, renewal refused, insurance cover cancelled or special terms applied? Yes No Select Yes or No

been involved or associated with the management of any Company, Partnership or Business which has ceased to trade following or as a result of the appointment of a receiver, liquidator, administrator or other insolvency practitioner? Yes No Select Yes or No

been involved or associated with the management of any Company, Partnership or Business with an administrator liquidator or a supervisor or nominee under a voluntary arrangement or any compromise or arrangement with creditors whether formal or informal ? Yes No Select Yes or No

been served with a prohibition or improvement order under health and safety legislation? Yes No Select Yes or No

had a county court judgement awarded against them? Yes No Select Yes or No

Number of Years Claims Free

Catch All

Trade Group

Trade

Buildings

Tenants Improvements

Business Contents (excluding Computers)

Computers and Electronic Equipment

All Other Stock

CDs, DVDs & Computer Games

Electronic Office Equipment

Cigarettes, Cigars & Tobacco

Wines & Spirits

Glass & Fixed Signs

Gross Income

Book Debts

Loss of Rent Receivable Yes No Select Yes or No

>>>>>>% of Buildings Sum Insured

>>>>>>Loss of Rent Receivable - LOI

Indemnity Period

Employers Liability Premium Yes No Select Yes or No

Public/Products Liability Premium Yes No Select Yes or No

Laptops, Computer equipment & Ancillary equipment

Mobile Phone & other communication equipment

Household Contents at the Premises

Household Contents Away from the Premises

Pedal Cycles Away from Your Home

1) Non-Negotiable Money

2) Money During Business Hours and in Transit

3) In a Locked Safe Outside Business Hours

Make and Model of the Safe

4) Not in a Locked Safe Outside of Business Hours

5) a. Death

5) b. Permanent Total Disablement

5) c. Temporary Total Disablement (per week)

5) d. Clothing and Personal Effects

Theft by Employees

Goods in Transit

Number of Vehicles

Loss of Licence

Frozen Food

Rating Area

Minimum Premium Factor Yes No Select Yes or No

Subsidence Score

Arson Score

Crime Score

Flood Score

Limit of Indemnity

APC Crime Area

Type of Cover

had any claims or lossess, at this address or any other, whether insured or not within the last five years, regardless of whether the claim was paid Yes No Select Yes or No

Number of Years Trading

Previous Management Experience in Trade Yes No Select Yes or No

Has the property been vacant prior to you opening the business? Yes No Select Yes or No

How many months vacant ?

Do you have any Subsidiary Companies? If yes, please provide additional company names and addresses Yes No Select Yes or No

If Your Business has more than 5 employees, is there a written Health & Safety policy incorporting Risk Assessments and Training in accordance with UK Legislation Yes No Select Yes or No

Is any work carried out away from the premises (other than delivery or collection)? Yes No Select Yes or No

If there is any delivery of goods, can you confirm that any vehicle used, whether owned by the business or not, are serviced and maintained as per the manufacturers recomendations? Yes No Select Yes or No

Is any manual work undertaken at the premises? If yes, please provide details. Yes No Select Yes or No

Is any manual work undertaken away from the premises? If yes, please provide details. Yes No Select Yes or No

Do you hold any Bonfire Celebrations, Firework or Pyrotechnic Displays? Yes No Select Yes or No

Are the Premises Built of Brick (including timber frame) stone, concrete walls, slate, tile or concrete roof, with no more than 20% of other materials? If No, please confirm: Yes No Select Yes or No

What is the construction of the walls ?

What is the type of roof ?

What is the construction of the roof ?

Is any of the roof thatched ? Yes No Select Yes or No

Are there any composite panels within the construction of the Premises? If Yes, please confirm the % of panels within the Building area?

Are these panels LPC approved Yes No Select Yes or No

Is the Property Listed Yes No Select Yes or No

Listed Grading

Does the Premises have an Open Fire or Log Burning Stove? Yes No Select Yes or No

Are all fire lighters kept at least 1 metre away ? Yes No Select Yes or No

Are all chimney flues to solid fuel boilers and open fires kept in a good state of repair and are professionally cleaned once a year before the winter months ? Yes No Select Yes or No

Can you confirm that all Log burning stoves are installed within building regulation guidelines and the necessary flue liner to HETAS regulations Yes No Select Yes or No

Are at least 2 fire extinguishers, one water and one powder, easily accessible and annually maintained Yes No Select Yes or No

Are the Premises known to have suffered from any flood claim, loss or event? Yes No Select Yes or No

Are the Premises more than 250 metres away from the nearest watercourse, river, canal, lake, tidal waterway or the sea? Yes No Select Yes or No

Are the Premises known to have suffered from flooding ? Yes No Select Yes or No

Are the Premises more than 250 metres away from the nearest river, canal, lake, tidal waterway or the sea? Yes No Select Yes or No

Please confirm what watercourse the Premises are near?

Please confirm the distance from the watercourse?

Are the Premises known to have had additional terms imposed for flood or excluded flood cover by any insurer? Yes No Select Yes or No

Have the premises previously suffered from Subsidence or movement? Yes No Select Yes or No

Do the premises meet all statutory obligations including fire safety, electrical inspections, Health & Safety and COSHH regulations relating to the Business and have in place a current Fire Certificate and a current Electrical Inspection Certificate Yes No Select Yes or No

Have you had the electrical installation tested by a certified NICEIC, ELECSA or ECA contractor and all reported defects remedied? Yes No Select Yes or No

Is the most recent Electrical Inspection certificate less than 5 years old? Yes No Select Yes or No

Are freezer cabinets less than 10 years old and is there a current maintenance agreement in force for any which are over 5 years old? Yes No Select Yes or No

All Premises including car parking area is maintained in a good state of repair. Yes No Select Yes or No

All public toilets and toilet areas cleaned on a daily basis and are checked regularly during opening hours, with this process being documented? Yes No Select Yes or No

All internal and external steps and staircases, handrails and lighting are in a good state of repair and regularly maintained Yes No Select Yes or No

Is the Premises self contained with full fire separation and occupied solely by Your Business with no unoccupied parts ? Yes No Select Yes or No

Is the Premises self contained and occupied solely by Your Business with no unoccupied parts ? Yes No Select Yes or No

If No, please give full details of all other occupants

Are all external doors of the Premises and any internal doors which give access to any part of the building not occupied by You, of solid construction and fitted with a mortice deadlock conforming to British Standard 3621 Yes No Select Yes or No

Are all accessible opening windows, fanlights and skylights, including those accessible from decks, roofs, fire escapes or downpipes, fitted with key operated window locks, except those opening windows protected by solid steel bars, grilles, expanded metal or weld mesh. Yes No Select Yes or No

Is the Premises protected by a monitored and maintained intruder alarm ? Yes No Select Yes or No

Alarm type

Is the intruder alarm installed in accordance with the specification or system record approved by Us and is put into full and effective operation at night and whenever the Premises are closed for business or left unattended Yes No Select Yes or No

Is the intruder alarm maintained under contract by a company which is either included in the official list of recognised firms of the National Approval Council for Security Systems (NACOSS) or approved by Us Yes No Select Yes or No

Are all keys of the intruder alarm removed from the Premises at night and whenever they are closed for business or left unattended Yes No Select Yes or No

Can you comply with the Alarm Condition ? Yes No Select Yes or No

Is there CCTV on the Premises ?

Is the CCTV recorded? Yes No Select Yes or No

Does the CCTV operate 24 hours per day and cover entrances, exits, stairs, bar area and any dance area? Yes No Select Yes or No

Does the CCTV operate 24 hours a day and cover entrances, exits and stairs? Yes No Select Yes or No

Are recordings stored for at least 60 days and kept off site, or within the premises in a fire resistant cabinet, or on a fixed hard drive which cannot be removed? Yes No Select Yes or No

What percentage of your turnover comes from Wholesale?

Does your business export any products to USA or Canada? If so, what % of turnover? Yes No Select Yes or No

Is your business closed for more than 60 consecutive days? Yes No Select Yes or No

Is the premises protected by 24hr manned security on site? Yes No Select Yes or No

Is there an ATM at the premises for which you are responsible? Yes No Select Yes or No

Is the ATM located inside the premises? Yes No Select Yes or No

Do you have a license to serve alcohol? Yes No Select Yes or No

Do you serve food and drink to residents only? Yes No Select Yes or No

If your business is open to serve food to non residents, please confirm the closing time?

Is the business ever open after 2am Yes No Select Yes or No

How many days is your Business open for trading on a weekly basis?

Do you operate any Door or Security Staff at the premises? Yes No Select Yes or No

Are they licenced by the SIA, covered by the liability insurance of a third party contractor and not employed directly by your company ? Yes No Select Yes or No

Is there any entertainment ? Yes No Select Yes or No

Number of Events per Year

Offer any entertainment other than Quiz Nights, Table Games, Karaoke, Solo and Duo Singers. If yes, please provide details. Yes No Select Yes or No

Do you have a DJ at the premises other than in any function room ? Yes No Select Yes or No

Do you have a dedicated dance floor or stage area or any other area thet is clear to allow for dancing other than within any function room. Yes No Select Yes or No

Do you have provision to hold weddings or private parties at the premises? Yes No Select Yes or No

Do you have a function room ? Yes No Select Yes or No

Capacity

Frequency of Events

How many functions are held at the premises in an annual period

Do you have any letting rooms? Yes No Select Yes or No

If so, please confirm the number of letting rooms available?

Are any letting rooms used only for business or tourist occupation? (eg. No student or DSS let) Yes No Select Yes or No

Is there a manager, employee or night porter on site at all times? Yes No Select Yes or No

Does your business have a swimming pool or any spa facilities? Yes No Select Yes or No

Are the facilities operated by you? Yes No Select Yes or No

Is access restricted to residents only? Yes No Select Yes or No

Is all equipment maintained and serviced as per the manufacturers instruction Yes No Select Yes or No

Are appropriate safety signs provided where necessary that give instructions on the safe use of the pool and / or equipment also making users full aware of pool rules and the need to be responsible for their own safety? Yes No Select Yes or No

Can you confirm that all equipment is structurally safe being operated and maintained in a safe manner, compliant with the relevant sections of the health and safety at work act 1974 Yes No Select Yes or No

In the absence of a lifeguard, can you confirm that a member of staff, who is trained in CPR, pool rescue and first aid, is designated as `on call` to respond immediately to any alarm and deal with any emergency? Yes No Select Yes or No

Please confirm visible written safety procedure highlighting pool opening times, no lifeguard, adult supervision of children, no swimmers should not swim alone, location and use of rescue equipment and how to use the alarm? Yes No Select Yes or No

Does your business have any gym facilities? Yes No Select Yes or No

Are the facilities operated by you? Yes No Select Yes or No

Is all equipment maintained, serviced and used as per the manufacturers instruction and inspected weekly with any defects being repaired immediately? Yes No Select Yes or No

Do you obtain a `Health & Gym experience questionnaire` form all members, participants and users? Yes No Select Yes or No

Can you confirm that where the member. Participant or user does not have the correct level of fitness and adequate induction course shall be provided? Yes No Select Yes or No

Do you offer any further leisure facilities? If so, please provide details. Yes No Select Yes or No

Does your business have childrens play equipment? Yes No Select Yes or No

Is the equipment maintained and serviced in accordance with the manufacturers instruction? Yes No Select Yes or No

Are there safety signs and where necessary instructions on the safe use of the equipment? Yes No Select Yes or No

Is all equipment structually safe and operated and maintained in a safe manner in accordance with the health and safety at work act ? Yes No Select Yes or No

Can you confirm that children under 12 are not allowed on any equipment unless supervised by an adult? Yes No Select Yes or No

Do you have a childrens soft play area or inflatables? Yes No Select Yes or No

Does your business serve food? Yes No Select Yes or No

If your business serves food, do you have a Food Standards Agency Hygiene Rating?

Do you undertake any frying? Yes No Select Yes or No

Frying Range - Stainless Steel - Less than 10 yrs old Yes No Select Yes or No

Frying Range - Mild or Mixed Steel - Less than 10 yrs old Yes No Select Yes or No

Frying Range - 10 Years or Older Yes No Select Yes or No

Any other frying equipment? Yes No Select Yes or No

How old is the frying equipment?

Are all frying and other cooking ranges, equipment, flues and exhaust ducting kept securely fixed and free from contact with combustible materials? Yes No Select Yes or No

Are all extraction hoods, canopies, filters and grease traps cleaned at least every 2 weeks? Yes No Select Yes or No

Are all extraction ducts cleaned regularly and maintained and checked at least once annually by a specialist contractor? Yes No Select Yes or No

Is the record of such cleaning and servicing of the extraction ducts kept elsewhere other than at the Premises and will be made available for inspection at any time? Yes No Select Yes or No

Can you confirm that all frying equipment will be installed, used and maintained in accordance with the manufacturer’s instructions Yes No Select Yes or No

Can you confirm that multi-purpose fire extinguishers and at least one fire retardant blanket which conforms to relevant British Standard suitable for extinguishing oil and fat fires will be kept in close proximity to the working area of the range and maintained ready for use Yes No Select Yes or No

Can you confirm that Frying ranges will not be left unattended whilst in use? Yes No Select Yes or No

Will all naked flames (other than pilot lights) and all electrical elements be turned off at the close of the working day? Yes No Select Yes or No

Does your business offer beauty treatments? Yes No Select Yes or No

Are all treatments carried out or under the direct supervision of a qualified person? Yes No Select Yes or No

Do you adere to all hygiene standard requirements and regulations? Yes No Select Yes or No

Can you confirm that your activities are limited to manicures, pedicures, facials, waxing, spray tanning, hairdressing and ear piercing? Yes No Select Yes or No

If you are involved in ear piercing can you confirm that needles will not be used more than once? Yes No Select Yes or No

Do you or any employee of the business live on the premises? Yes No Select Yes or No

Are there any deliveries by moped? Yes No Select Yes or No

Additional information

Policy Information Booklet

Policy Wording

Why choose us

Over £330 million gross premium written
Fully transparent custom policies to suit you
Proud to deliver to both direct and wholesale clients
Award-winning in-house claims team
Broker at Lloyds of London