Commercial Combined Enquiry Form
Please complete the enquiry form below and click submit or alternatively call us for assistance on 023 8026 9009
  • (If more than one trading name you must provide the different ERN’s)
  • 1 - Material Damage

    If not required please proceed to section 2
  • Please state values to be insured:
  • 2 - Business Interruption

    If not required please proceed to section 3
  • months
  • If loss of Book Debts cover required please answer the following questions:
  • 3 - Liabilities

    If not required please proceed to section 4

    Employers Liability included at £10,000,000
  • Employer’s Liability
    State total estimated wages for the forthcoming year in respect of the following:
  • Public and Products Liability
    State total estimated turnover for the forthcoming year in respect of:
  • Other Counties - Please specify below
  • Health and Safety

  • If YES please answer the following questions otherwise skip to the next section
  • Have you carried out the following assessments in respect of the Management of Health and Safety At Work Regulations 1999? (If applicable to the type of business)
  • 4 - Glass

    If not required please proceed to section 5
  • 5 - Money

    If not required please proceed to section 6

    State estimated total carryings per annum (including all transits TO and FROM the Bank or Post Office, collections and deliveries TO and FROM other offices and clients etc).
  • State limits required:
  • 6 - Goods In Transit

    If not required please proceed to section 7
  • State total value of goods carried during the year for the following:
  • 7 - Loss of Liquor License

    If not required please proceed to section 8
  • 8 - Deterioration of Food

    If not required please proceed to section 9

    State in respect of each refrigerator or cabinet
  • Description Age Stock Limit
    1
    2
    3
    4
  • 9 - General Questions - Must be Answered

    Give brief description of the premises to be insured:
  • If you answer yes to any of the first three options, please provide further information in the box at the end of the form
  • / /
  • PLEASE INDICATE YOUR ACCEPTANCE BY CLICKING 'I HAVE READ AND AGREE TO THE TERMS & CONDITIONS'

    Our terms and conditions can be read on our website at www.norrisandfisher.com/terms

    Norris and Fisher (Insurance Brokers) Ltd complies with the requirements of the Data Protection Act (DPA) 1998 and General Data Protection Regulations (GDPR) 2018. This Act places legal obligations upon Norris and Fisher (Insurance Brokers) Ltd in respect of the way we collect, review, distribute and store personal data.

    In order to assess your application and help us reach a decision, we need to process relevant personal details. By signing this form, you are giving your consent for Norris and Fisher (Insurance Brokers) Ltd to do this.
  • Image Verification
    captcha
    Please enter the text from the image:
    [Refresh Image] [What's This?]