• Commercial Express: Hobby and Club

  • Disclosure

  • IMPORTANT NOTICE: Please check this proposal/statement of fact for insurance very carefully

    The proposal/statement of fact, together with any other information supplied to the Insurers must not be misleading or incomplete and shall from the basis of the contract with the Insurers and shall be incorporated therein. If you are aware (having made all due enquires) of any information not specifically in the proposal/statement of fact but which may have a material bearing upon the Insurer's decision on whether ot not to provide cover or the terms upon which such cover would be provided, you must notify the Insurer via yur intermediary of it before the contract of Insurance is concluded and obtained their specified conformation that they are willing to proceed. You must inform Insurers via your intermediary of any material alteration or additions to the statements or particulars contained within this proposal/statement of fact, which occur before any contract of Insurance based on this proposal/statement of fact is effected.

  • Insured

  • The following proposal/statement of fact, together with any information supplied to the Insurers, will form the basis of the insurance and any non-disclosure or misrepresentaion of a material fact could invalidate all or part of the Insurance contract.
    A material fact is a fact likely to influence insurers assignment risk. If you are in any doubt as to what constitutes a material fact you should consult your colleague or Commercial Express.

  • Insured businesses

  • Does the above trade match exactly the insured trades?

  • Does the above trade match exactly the insured trades

  • Outside England, Scotland Wales or Northern Ireland?

  • Does the insured undertake or intend any activities on or at

  • i) Hospitals or Farms?
  • ii) Chemical or Gasworks?
  • iii) Oil refineries or Power Stations?
  • iv) Aircraft's, Airports, Watercraft?
  • v) Offshore installations?

  • Sums insured

  • Cover required

  • All risks

  • Do you require cover for All Risks away from the premises?

  • Excesses

  • Employer reference number (ERN) / Employer PAYE reference

    Only a very tiny minority of employers that do not pay salaries through PAYE are exempt from an ERN. All employers who pay PAYE must provide ERN.
  • Is the company exempt from having an ERN?

  • Disclosure and claims

    Has the insured:
  • a) Ever had insurance cover refused or cancelled or special terms imposed?
  • b) or insured family member ever been convinced or cautioned with any criminal offence, other than driving offences?
  • c) Ever had any claims or incidents at these or any other premises in the last 5 years?
  • d) Been prosecuted under Health & Safety at Work Act, Consumer Protection Act or other relations?
  • e) Ever been declared bankrupt or been the subject of any winding up petition or order in this or any previous business?

  • Additional information

  • Any further information or material facts you should or would like to advise Underwriters?
  • I can confirm i have read and understood all the questions relating to this quotation.*
  • Should be Empty: