Welcome to Waveney Insurance Brokers

Removers & Storers Insurance

Complete the short form below to get a quotation or call  01362 850707

Existing Insurer Details
Renewal Date:		DD/MM/YY
Renewal Premium (£):
Insurer/Broker:
Customer Details
Proposer's Name
Address
Number/Name
Street
Town/ County
Postcode
Telephone Number
Email address
Web Addres
Memberships
Advise if members of		Select All That Apply BAR The Guild Of Removers & Storers SSA UK Any Other
Other Memberships
Cover
Employers Liability Insurance Required		yes  no
Public / Products Liability Insurance Required		yes  no
If Public / Products Liability Insurance required State Limit		£2 Million £5 Million Other
Wages Estimates
Clerical/Estimating
Drivers/Porters
Warehouse
Other Please Specify
Claims Experience
How long has the proposer been in business yrs				Any claims in last 5 years?			yes
							no
If yes, please provide following details:
Type of Claim				Payment made £			Date
Activities
Domestic Removals/Storage	Continental Removals/Storage	International Shipments			Self Storage
Archive Storage	Maid Service	Any Other	Specify Other
Estimated Turnover