Venue Name:

Venue Address:

Post Code:

Intruder Alarm:
Yes No

Intruder Alarm Linked to Central Station:
Yes No

Redcare Intruder Alarm:
Yes No

Fire Alarm:
Yes No

Fire Alarm Linked to Fire Station:
Yes No

Recorded Internal CCTV:
Yes No

Recorded External CCTV:
Yes No

Time trading / previous experience if new venture:

Details of claims occurred in the last five years:

Claim 1

Date:

Incident:

Claim 2

Date:

Incident:

Claim 3

Date:

Incident:

Claim 4

Date:

Incident:

Have you had more claims than those detailed above?
Yes No

If so, how many?

Renewal Date:

Sums Insured

Buildings:

Trade Contents:

Stock of Beers:

Stock of Wines & Spirits:

Stock (excluding the above):

Turnover:

Estimated Gross Profit:

Annual Wages

• Bar Staff:

• Doorman (own employees):

• Doorman (agency employees):

• Managerial / Clerical:

Internal Glass:

External Glass:

Goods in Transit:

Money

Estimated annual carryings (own):

Estimated annual carryings (sec comp):

Contact Details

Your name:

Your e-mail:

Please re-confirm your e-mail address:

Would you like to be contacted about above quote by phone?
Yes No

Your telephone number:

Would you like to be notified of other products or services which might be of interest to you?
Yes No