Fire and Allied Perils Insurance

Firm Insurance Brokers Limited Information Sheet - Please answer the following sets of questions to the best of your ability.
Full Name :
Postal Address :
City :
Risk Address :
Phone Number(s) :
Fax No. :
E-mail Address :
Best time to call :
Business or Profession :
Name of Mortgagee
Address of Mortgagee :
 
Building
 
Construction of building :
Walls :
Roof :
Claims within Last three years :
Previous Insurance Company :
 
Items to be Insured
Sum Insured
 
Building :
Plant, Machinery & Equipment :
Office Furniture, Fixtures & Fittings :
Stock in trade :
Stationery etc :
Any other :