Heating and Ventilation | Proposal Forms

Electrical Contractors Liability Proposal

Proposer's Full Name

Include all subsidiary companies to be insured
If the Proposer is not a limited company specify any trading names and the names of all principals and partners

Quotation required by (date)
Target premium	£

Business Details

1. When was the business established?

2. Full description of trade or business

3. Are you

		a) a member of a trade body or association?	Yes No
		b) accredited or registered with an approvals or certification body in respect of the work you undertake?	Yes No

		If Yes, please provide details including your membership/registration number(s):

4. What is your estimated Gross Annual turnover for the next twelve months based on the following activities?

a) Electrical Contracting	£
b) Mechanical Heating, Ventilation and Air Conditioning Contracting	£
c) Intruder alarm systems protecting private dwellings only	£
d) All other Intruder alarm systems	£
e) Fire alarm systems protecting private dwellings only	£
f) All other fire alarm systems	£

Registered in England: Number 608819
Authorised and Regulated by the Financial Services Authority

Registered Office:
Lygon House, 50 London Road, Bromley, Kent. BR1 3RA