Sports and Social - Proposal Form
1. Name and Address of the Insured
Post code
2. Trading Name of the Insured
3. Full description of Clubs Activities
The Premises
1. Address of premises to be insured (if different from above)
2. Are the premises constructed of brick, stone, concrete and roofed with slates, tiles, concrete or asphalt and in a good state of repair?
Yes No
Are there any outbuildings?
Yes No
If yes, please give details
3. Age of premises
4. In what type of area are the premises situated?
    a) Residential
Yes No
    b) Industrial
Yes No
    c) Commercial
Yes No
    d) Rural
Yes No
5. Number of Storeys
6. Is there a cellar or basement?
Yes No
7. Do you occupy the whole of the premises?
Yes No
If no,
 
     a) what parts fo you occupy?
 
b) what is the occupancy
of the other parts?
8. Has there been any history of flooding in the area?
Yes No
9. How far are the premises from a full time Police Station?
10. How far are the premises from a full time Fire Station?
11. How are the premises heated?
   
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Registered in England: Number 608819
Authorised and Regulated by the Financial Services Authority
Registered Office:
Lygon House, 50 London Road, Bromley, Kent. BR1 3RA