Call us on: 01494 77 37 77

To request a quote please fill in the following information as accurately as possible. Please note that we may need to call you before providing a quote if we are unsure of any details.


Proposer *

Date of Birth *

Occupation *

Email *


Address to be insured including postcode *

Is the property in a good state of repair? *
No of occupants (above/under 18)

Is the property unoccupied in the day or night?
usually occupied day and nightunoccupied during the dayunoccupied overnight
Are any occupants smokers?
No of bedrooms *

No of bathrooms *

Year property was built

Type of property *

Wall type *

Roof type *

Percentage of roof that is flat

Is the property used for business?
What kind of locks do you have on your windows and external doors?

Does the property have a security alarm?
Does the property have any fire precautions?
Who owns the property? *

Is there an interested party i.e. mortgage holder
Is the property within 400 metres of a river or quarry?
Has the property experienced landslip, subsidence, heave?
Have any special terms or conditions ever been applied to insurance for this property?'

Number of years claim free *


Buildings cover required *

Is accidental damage cover required?*
Detail any claims you have made in the past 5 years

Contents cover required

Total sum of specified items within contents cover *

Unspecified items away from home

Specified items away from home

Number of years claims free

Your privacy: We will not store or use your details for any other purpose other than to correspond with you about this enquiry. You can read our privacy policy here