Welcome to Waveney Insurance Brokers

Removers & Storers Insurance

Complete the short form below to get a quotation or call 01473 269443

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 Address
Memberships
Advise if members of		Select All That Apply BAR The Guild Of Removers & Storers SSA UK Any Other
Other Memberships
Cover
Own or Lease Warehouse		Select Yes No
If No Whose Facilities Do You Use For Storage
Claims Experience
How long has the proposer been in business yrs				Any claims in last 3 years?			yes
							no
If yes, please provide following details:
Type of Claim				Payment made £			Date
Security
Do you have window locks on all accessible windows?		yes  no
Do you have 5 lever mortice deadlocks on all entrance and final exit doors at the premises?		yes  no
Is there an alarm at the premises?		yes  no
Name of Alarm Co
Is it maintained under an annual contract?		yes  no
What is the signal method?
Are the premises protected by local authority CCTV?		yes  no
Subsidence Details
Is the Property in a Flood, Subsidence, Heave or Landslide Area?		yes  no
If YES, please give details
Activities
Domestic Removals/Storage	Continental Removals/Storage	International Shipments			Self Storage
Archive Storage	Maid Service	Any Other	Specify Other
Estimated Turnover		Number Of Vehicles