From what date is cover required?
*
/
Day
/
Month
Year
Who is your current/previous insurer?
*
How long have you been trading?
*
Please Select
0 years
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10+ years
Please state your annual income (gross income excluding VAT)
*
What level of public liability cover do you require?
*
£5m
£10m
Do you have a license to board cats and/or dogs?
*
Yes
No
What star rating is your boarding licence?
*
Please Select
1 star
2 star
3 star
4 star
5 star
How many dogs are you licenced to board?
*
How many cats are you licenced to board?
*
What is the maximum number of dogs you board at any one time during your busiest periods?
*
What is the maximum number of cats you board at any one time during your busiest periods?
*
What is the maximum number of small domestic pets you board at any one time during your busiest periods?
*
Do you sell pet supplies to the public?
*
Yes
No
What is your annual turnover from this activity?
*
Do you offer dog warden services?
*
Yes
No
Do you board council stray animals?
*
Yes - up to a maximum of 400 per year
Yes - up to a maximum of 1000 per year
No
Do you board Specially Controlled Dogs (banned breeds)?
*
Yes
No
Do you offer spaces for pet rescues?
*
Yes
No
How many rescue dogs do you board each year?
*
How many rescue cats do you board each year?
*
How many rescue small domestic pets do you board each year?
*
Do you undertake dog grooming or microchipping of non-boarders?
*
Yes
No
What is your annual turnover from this activity?
*
Do you provide hydrotherapy services?
*
Yes
No
What is your annual turnover from this activity?
*
Do you provide dog training services?
*
Yes
No
What is your annual turnover from this activity?
*
If you offer training or hydrotherapy services, do you require professional indemnity insurance?
*
Yes
No
Do you provide dog day care services?
*
Yes
No
What is your annual turnover from this activity?
*
Do you undertake any other activities?
*
Yes
No
Please give details
*
Do you require cover for vet fees, loss from theft or straying, advertising and reward?
*
Yes
No
Do you have any paid or unpaid staff or helpers?
*
Yes
No
Please state your annual clerical wageroll
*
Please state your annual manual wageroll
*
Do you take on work experience students from schools or colleges?
*
Yes
No
If yes, how many work experience students would you have on-site at any one time?
Have there been any claims made in the last 3 years?
*
Yes
No
If yes, please advise the date of loss, loss type and the amount claimed.
Do you require cover for property damage
*
Yes
No
Buildings?
*
Yes
No
Please state rebuilding cost
*
Please give details of construction, including roofing materials
*
Fixed glass and lettering?
*
Yes
No
Please state rebuilding cost
*
Stock, straw, bedding and feedstuffs?
*
Yes
No
Please state replacement cost
*
Small hand tools?
*
Yes
No
Please state replacement cost
*
Machinery and fixed equipment?
*
Yes
No
Please state replacement cost
*
Commercial contents?
*
Yes
No
Please state replacement cost
*
Computer and office equipment?
*
Yes
No
Please state replacement cost
*
Laptops?
*
Yes
No
Please state replacement cost
*
Business interruption? (Based on 100% turnover)
*
Yes
No
Theft of money?
*
Yes
No
Do you require cover for anything else?
*
Yes
No
Please describe
*
Please detail what physical security you have at the premises. e.g. CCTV, security lighting
*
Loss of Animal Boarding Establishment Act licence?
*
Yes
No
Deterioration of chilled stock/freezer contents?
*
Yes
No
If yes, please provide a value for your chilled stock/freezer contents.
Do you require personal accident cover whilst working?
*
Yes
No
If yes, how many people is personal accident cover required for whilst working?
How would you prefer to be contacted by Cliverton?
Phone
Email
Please select the option which best describes your business:
*
Please Select
Limited Company
Trading As
Sole Trader
Title
*
Please Select
Dr
Miss
Mr
Mrs
Ms
Prof
Rev'd
Name
*
First name
Last name
Date of Birth
*
/
Day
/
Month
Year
Address
*
Address line 1
Address line 2
City
Postcode
Email
*
Confirmation Email
Confirm email
Telephone
*
Please enter a valid phone number.
Is a joint policy required?
*
Yes
No
Title
*
Please Select
Dr
Miss
Mr
Mrs
Ms
Prof
Rev'd
Name
*
First name
Last name
Date of birth
*
/
Day
/
Month
Year
SUBMIT
Should be Empty: