About You.

Your Name

Your Address

Contact Details

Renewal Date

Property Information

Type of property

Trade of tenant

Is there a residential part to the building?

Type of residential tenant?

Cover Required.

Building (£)

This should be a rebuild value

Landlords Contents (£)

This should the landlords contents

Previous Claims?

Claims in past 5 years?

Please give details

When did this occur?

What were the costs of claim