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
  • Personal Details:

  • Business Details:

  • Please give a short description of your business.
  • Sum Insured Details:

  • Security Details: