Unoccupied Buildings Proposal Form
1. Name of Proposer and Trading Title (if any)
2. Your Address
 Post Code
3. Address of the premises to which this Insurance will apply
 Post Code
 
4. If you are not the owner please indicate interest
5. Proposer's Business Description
 
6. Describe the premises:
  (i) Are they:
 House
 Flat
 Shop
 Office
 Industrial
  Other (please describe)
  
 
  (ii) Are they:
 Terraced
 Semi-Detached
 Detached
  (iii) Number of Floors
  (iv) Approx. age
  (v) Approx. size
  (vi) Are the premises Grade Listed?
Yes No
 If so, please state which Grade
7. State Construction:
(a) External walls of the building
(b) Roof
(c) Floors
(d) Are there areas of non-standard construction (e.g. Flat Roofs), if so please describe:-
   
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