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Irish Shop Insurance Form
Acceptability Criteria
The property to be insured:
• Is in good repair and will be so maintained.
• Is of Standard Construction (constructed of brick, stone or concrete and roofed with slates, tiles, asphalt, metal or concrete)
• Must NOT have been previously flooded, be located in an area which has previously flooded or be particularly exposed to flood damage
• Must NEVER have shown signs of subsidence, heave or landslip, coastal or river erosion or be located in an area exposed to such damage
The proposer or any director, partner or Princial of the business:
• Must NEVER have been convicted of or charged with (but not yet tried for) any criminal offence, (other than a motoring offence)
• Must NEVER have been refused insurance, had special terms or conditions imposed, or had insurance cancelled or renewal refused
• Must NOT, in the past 5 years, have incurred any claims or suffered any losses for any of the perils or contingencies to which this insurance apples
I Agree:
*
Yes
No
Personal Details:
Title:
*
Please select
Mr
Mrs
Miss
Ms
Full Name:
*
First
Last
Street Address:
*
Address Line 2:
Town/City:
*
County:
*
Eircode:
Phone
*
Email
*
Business Details:
Business Name:
*
Business Desciption:
*
Please give a short description of your business.
Annual Turnover:
*
€
Euros
Number of Employees:
*
Please select
0
1
2
3
4
5
6
7
8
9
10
Sum Insured Details:
Buildings (incl. landlords fixtures & fittings & Tenants improvements):
*
€
Euros
Contents:
*
€
Euros
Business Disruption:
*
€
Euros
Security Details:
Alarm:
*
Please select
None
Working alarm with exterior bell/siren
NSAI approved with central monitoring
Security Level:
*
Please select
None
5 Lever Mortice deadlock & window locks
Roller Shutters on all ground floor windows/doors
Does property open onto an enclosed area?
*
Please select
Yes
No
Does anyone live on the premises?
*
Please select
Yes
No
If Yes, How Many Employees Are Involved?
*
Please select
1
2
3
4
5
Is work done away from premises?
*
Please select
Yes
No