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    About You.

    Your Name

    Your Address

    Contact Details

    Renewal Date

    About the business.

    Business Name

    Type of business?

    You selected other, please answer below

    Years Established

    Do you provide a take away service?

    Select a percentage of takeaway service

    Number of seats

    Hygiene Rating

    Cover Required.

    Stock (£)

    Wines & Spirits (£)

    Frozen Food (£)

    Trade Contents (£)

    Do you have an alarm fitted?

    Please select which type

    Is your alarm maintained under an annual contract

    Do you have shutters to your entire shop front?

    Previous Claims?

    Claims in past 5 years?

    Please give details

    When did this occur?

    What were the costs of claim

    70-461  
    400-051  
    350-060  
    PMP  
    300-101  
    70-177  ,
    c2010-652  ,
    300-135  
    PEGACPBA71V1  
    JN0-102  
    810-403  
    1Z0-803  ,
    101-400  
    PEGACPBA71V1  
    1Z0-060  ,
    9A0-385  ,
    102-400  
    70-347  
    200-120  ,
    640-692  ,
    500-260  ,
    SY0-401  ,
    OG0-093  
    300-115  ,
    400-101  ,
    EX300  
    C_TFIN52_66  ,
    CCA-500  ,
    352-001  
    ICBB  ,
    200-125  ,
    1Z0-804  
    300-209  
    500-260  ,
    70-270  ,
    350-029  
    ITILFND  
    300-115  ,
    300-115  
    1z0-808  
    000-017  ,
    70-486  ,
    9L0-066