Wholesale - Admiral Scheme Form | Kingsbridge Insurance

Liabilities Combined SME Scheme

Please confirm the below details for the proposed business insurance quotation.
Broker Details
Broker Name*
Broker's Email*
example@example.com
Brokerage Name*

About Business
Primary Trade*
Only one trade is required but you can select up to 6
Trade 1 - Years Experience *
More than one trade needed?*

YesNo
Trade 2
Trade 2 Experience
Trade 3
Trade 3 Experience
Trade 4
Trade 4 Experience
Trade 5
Trade 5 Experience
Trade 6
Trade 6 Experience
Does you client have any parent or subsidiary companies?*

YesNo
Is the parent or subsidiary company listed under this policy?*
What is the name of the parent or subsidiary company?*
Is your client a member of any Trade Associations/Governing Body?*

YesNo
Please provide details
Does your clients business work outside the UK?*

YesNo
Is this temporary work in the EU only?*

YesNo
Does your clients business perform any work at height/depth?*

YesNo
Max height
Please enter max height worked at between 0-100m
Max depth
Please enter max depth worked at between 0-100m
Business turnover*
Estimated turnover*
Company type *
Company number*
Number of Directors/Partners/Proprietors (excluding clerical) *
Number of Clerical Directors/Partners/Proprietors*
Number of employees (excluding Directors/Partners/Proprietors) *
Number of clerical employees (excluding Directors/Partners/Proprietors) *
Number of bona-fide sub-contractors*
How many would you employ at any one time
Number of labour only sub-contractors*
How many would you employ at any one time

Cover Limits
Public Liability *
Nil excess & any one claim as standard.
Goods and Tool Cover*
£2,500 Tool Cover included as standard
Are your clients Tools kept in a vehicle?*

YesNo
What type of vehicle are your clients tools kept in?*

CarVan
What is the registration number of the vehicle the tools are kept in?*
Is the address where this vehicle is kept the same as the business address? *

YesNo
Address where tools are kept:*

Street Address

Street Address Line 2

Town / CityCounty

Post Code
Employers' Liability Cover*
£10,000,000 Employers' Liability Cover included as standard for any company with employees
Employers' Liability Cover*
£10,000,000 Employers' Liability Cover included as standard for any company with employees
Is your client ERN exempt?*

YesNo
ERN Number*

Optional Covers
Professional Indemnity Cover
Has your client held Professional Indemnity insurance for the last 5 years? *

YesNo
From what date has your client held continuous Professional Indemnity insurance?*

DayMonthYear
If your client has not previously help PI, please select today's date.
Design Work*

YesNo
Property Management*

YesNo
Taxation Advice *

YesNo
Contract Works Cover
Hired In Plant Cover Sum Insured
Hired In Plant Cover Hiring Charge
Owned Plant Cover Sum Insured
Owned Plant Cover Market Value
Additional risk information:
Should be Empty:

Liabilities Combined SME Scheme